| NPI | 1851313746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM DAVID KEISNER President 479-855-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 2511) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |