| NPI | 1770688863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTGOMERY D. HEATHMAN President CEO 479-756-6155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3333) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2008-10-08 |