| NPI | 1982767547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED WILSON JOLLEY Dentist 501-847-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AR 3389) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |