| Ascension Depaul Services | |
|
407 South Gould Ave Gould AR 71643 | |
| (870) 263-4317 | |
| (870) 263-4782 |
| Full Name | Ascension Depaul Services |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 407 South Gould Ave, Gould, Arkansas |
| Authorized Official Name and Position | Lisa Goodgame (CFO) |
| Authorized Official Contact | 8703823080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Depaul Services Po Box 158 Dumas AR 71639-0158 Ph: (870) 382-3080 | Ascension Depaul Services 407 South Gould Ave Gould AR 71643 Ph: (870) 263-4317 |
| NPI Number | 1689890063 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 03/31/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689890063 | NPI | - | NPPES |
| 149324631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |