| NPI | 1952504615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ALAN STATON President 479-452-1738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 2566) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2020-08-22 |