| Prairie Grove Dental Center Pllc | |
|
1121 E Heritage Pkwy Prairie Grove AR 72753-6013 | |
| (479) 244-2052 | |
| (479) 846-1940 |
| Full Name | Prairie Grove Dental Center Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1121 E Heritage Pkwy, Prairie Grove, Arkansas |
| Authorized Official Name and Position | Alan Douglas Clark (DENTIST-OWNER) |
| Authorized Official Contact | 4792442052 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Grove Dental Center Pllc 1121 E Heritage Pkwy Prairie Grove AR 72753-6013 Ph: (479) 244-2052 | Prairie Grove Dental Center Pllc 1121 E Heritage Pkwy Prairie Grove AR 72753-6013 Ph: (479) 244-2052 |
| NPI Number | 1508454612 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 01/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508454612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
John Pardo, Dds , Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Buchanan St, Prairie Grove, AR 72753 Phone: 479-846-1005 | |
Brad H Green Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Buchanan, Prairie Grove, AR 72753 Phone: 479-846-1005 |