| NPI | 1952587107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA RUSSELL CROSS Owner 479-966-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AR 3491) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2015-01-22 |