| NPI | 1952723215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIAN C DIETZ Owner Dentist 479-715-4277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3913) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-01-06 |