| |
255 W Broadway St West Memphis AR 72301-3903 | |
(870) 225-2500 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 255 W Broadway St, West Memphis, Arkansas |
Authorized Official Name and Position | Misti Ross (INS DIRECTOR) |
Authorized Official Contact | 8703363732 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1804 Old Greensboro Rd Bldg B Jonesboro AR 72405-0003 Ph: (870) 336-3732 | 255 W Broadway St West Memphis AR 72301-3903 Ph: (870) 225-2500 |
NPI Number | 1770848681 |
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Provider Enumeration Date | 07/06/2012 |
Last Update Date | 10/14/2020 |
Identifier | Type | State | Issuer |
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1770848681 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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