| Kenton A Ross, Dmd, Pa | |
|
106 N Locust Ave Fayetteville AR 72701-5114 | |
| (479) 973-9800 | |
| (479) 973-9246 |
| Full Name | Kenton A Ross, Dmd, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 106 N Locust Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Kenton A Ross (OWNER) |
| Authorized Official Contact | 4799739800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenton A Ross, Dmd, Pa 106 N Locust Ave Fayetteville AR 72701-5114 Ph: (479) 973-9800 | Kenton A Ross, Dmd, Pa 106 N Locust Ave Fayetteville AR 72701-5114 Ph: (479) 973-9800 |
| NPI Number | 1356469506 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356469506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3174 (Arkansas) | Primary |
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