| NPI | 1790909752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH I WOOD Doctor 870-931-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 2738) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-18 |