| NPI | 1891077236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JACKSON Office Manager 501-227-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 2463) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |