| NPI | 1821001637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY SPANGLER Office Manager 501-228-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: AR 3423) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: AR 3352) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-10-10 |