| Jonesboro Pediatric Dental Group | |
|
620 Southwest Dr Jonesboro AR 72401-5859 | |
| (870) 336-9700 | |
| Not Available |
| Full Name | Jonesboro Pediatric Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 620 Southwest Dr, Jonesboro, Arkansas |
| Authorized Official Name and Position | Summer Barker Tyson (OWNER) |
| Authorized Official Contact | 8703369700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonesboro Pediatric Dental Group 620 Southwest Dr Jonesboro AR 72401-5859 Ph: (870) 336-9700 | Jonesboro Pediatric Dental Group 620 Southwest Dr Jonesboro AR 72401-5859 Ph: (870) 336-9700 |
| NPI Number | 1538453006 |
|---|---|
| Provider Enumeration Date | 06/02/2011 |
| Last Update Date | 08/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538453006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3680 (Arkansas) | Primary |
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