| NPI | 1912318031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JO ATKINSON Business Staff 501-262-4010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 16) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-06-02 |