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3105 W Main St Russellville AR 72801-2454 | |
| (459) 968-1001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3105 W Main St, Russellville, Arkansas |
| Authorized Official Name and Position | Pam D Frost (OFFICE COORDINATOR) |
| Authorized Official Contact | 4799681001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3105 W Main St Russellville AR 72801-2454 Ph: (459) 968-1001 | 3105 W Main St Russellville AR 72801-2454 Ph: (459) 968-1001 |
| NPI Number | 1558574905 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558574905 | NPI | - | NPPES |
| 162329631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3117 (Arkansas) | Primary |
Drs Johnston & Richardson Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1610 W C Pl, Russellville, AR 72801 Phone: 479-968-8338 Fax: 479-968-1688 | |
Richard L Morgan Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1700 West C Place, Russellville, AR 72801 Phone: 479-968-1470 Fax: 479-968-7282 | |
Drs. Johnston & Lawrence Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1610 W C Pl, Russellville, AR 72801 Phone: 479-968-8338 Fax: 479-968-1688 | |
Dr. Douglas A. Griffin D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Phoenix Ave, Russellville, AR 72801 Phone: 479-968-1655 | |