| NPI | 1871838128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MATTHEW FULMER President 501-327-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: AR 3582) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |