| NPI | 1972930295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN D. HALL Member/Manager 479-254-6899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AR 3599) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |