| NPI | 1811051949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF FUSILIER President 501-922-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2025-04-01 |