| NPI | 1700914173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON R NANCE Office Administrator 479-524-9379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3369) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |