| NPI | 1861087470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL PHILLIPS Sr. Billing/Systems Manager 501-364-2526 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2021-03-05 |