| NPI | 1992056998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN NICHOLAS CLARK President 479-466-3834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3810) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |