| NPI | 1881018786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T MAHON Owner 479-621-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AR 2401) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AR 2401) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |