| NPI | 1902053978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LYNN OUELLETTE Dentist 501-847-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3289) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |