NPI | 1962915959 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM REYNOLDS LITTLE Owner 870-243-4406 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3930) |
Enumeration Date | 2017-11-13 |
Last Update Date | 2017-11-13 |