| NPI | 1710105622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE S BRANCH Office Manager 870-741-3877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-11-24 |