| NPI | 1861901985 |
|---|---|
| Other Name | CHICOT MEMORIAL MEDICAL CENTER DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | SUSAN VAUGHN CFO 870-265-9229 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2017-09-20 |
| Last Update Date | 2018-06-16 |