| Austin Family Dentistry Pa | |
|
3201 Club Manor Suite A Maumelle AR 72113 | |
| (501) 851-3262 | |
| (501) 851-3766 |
| Full Name | Austin Family Dentistry Pa |
|---|---|
| Speciality | Dentist |
| Location | 3201 Club Manor, Maumelle, Arkansas |
| Authorized Official Name and Position | Bryan A Austin (OWNER PRES) |
| Authorized Official Contact | 5018513262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Family Dentistry Pa 3201 Club Manor Suite A Maumelle AR 72113 Ph: (501) 851-3262 | Austin Family Dentistry Pa 3201 Club Manor Suite A Maumelle AR 72113 Ph: (501) 851-3262 |
| NPI Number | 1255415956 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 05/06/2013 |
| Medicare PECOS PAC ID | 9436384864 |
|---|---|
| Medicare Enrollment ID | O20131021000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255415956 | NPI | - | NPPES |
| 1871870 | Other | UCCI DR CLINT FULKS | |
| 828326 | Other | UCCI DR BRYAN A AUSTIN | |
| 58662 | Other | AR | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | AR3057 (Arkansas) | Secondary |
| 122300000X | Dentist | AR3521 (Arkansas) | Primary |
Maumelle Family Dentistry, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Club Manor Dr Ste 4, Maumelle, AR 72113 Phone: 501-851-1414 | |
Dw Smiles Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Club Manor Dr Ste 4, Maumelle, AR 72113 Phone: 501-851-1414 | |
Maumelle Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Club Manor Dr Ste 4, Maumelle, AR 72113 Phone: 501-851-1414 Fax: 501-851-6036 |