| NPI | 1740480847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIANDREA LYNN HIGGINS Business Administrator 870-935-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3096) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2008-02-27 |