| NPI | 1861667131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM AUSTIN SPADES Owner/Dentist 870-910-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3299) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |