Organization
ST FRANCIS HOUSE NWA, INC
Active
Other names
Owl Creek School Based Health Center Dental
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GRISHAM (EXECUTIVE DIRECTOR)
(479) 751-7417
Entity
Organization
Contact information
Practice address
375 N RUPPLE RD, FAYETTEVILLE, AR 72704-6110
(479) 751-7417
(479) 751-4898
Mailing address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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