Lake City Dental Clinic | |
1009 Highway 18 Lake City AR 72437-9622 | |
(870) 237-9928 | |
(870) 237-1012 |
Full Name | Lake City Dental Clinic |
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Speciality | Clinic/center - Dental |
Location | 1009 Highway 18, Lake City, Arkansas |
Authorized Official Name and Position | Steven F Collier (CEO) |
Authorized Official Contact | 8703472534 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lake City Dental Clinic Po Box 497 Augusta AR 72006-0497 Ph: (870) 237-9928 | Lake City Dental Clinic 1009 Highway 18 Lake City AR 72437-9622 Ph: (870) 237-9928 |
NPI Number | 1861654006 |
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Provider Enumeration Date | 06/30/2008 |
Last Update Date | 07/07/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861654006 | NPI | - | NPPES |
171779631 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |