| NPI | 1982063368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY CALANDRO CEO 479-437-3449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2020-01-19 |