| NPI | 1780060822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN KYLE DALTON President 501-733-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 3441) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AR 2841) |
| 1223G0001X Dentist, General Practice (Licence: TN 10106) | |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |