| NPI | 1881339687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA TURNER Director Of Business Operations 870-826-1576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |