| Jimmy Brown Dental | |
|
310 Ashley St. Star City AR 71667 | |
| (650) 419-2545 | |
| (855) 854-6281 |
| Full Name | Jimmy Brown Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 310 Ashley St., Star City, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jimmy Brown Dental Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Jimmy Brown Dental 310 Ashley St. Star City AR 71667 Ph: (650) 419-2545 |
| NPI Number | 1609379346 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 07/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609379346 | NPI | - | NPPES |
| 226030631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Star City High School Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 E Arkansas St, Star City, AR 71667 Phone: 870-628-5110 Fax: 855-854-6281 | |
Star City Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 W Bradley St, Star City, AR 71667 Phone: 870-628-5131 | |
Star City Community Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 557 Kirkwood Rd, Star City, AR 71667 Phone: 870-628-5110 Fax: 855-854-6281 |