| Shannon Candid Arkansas, P.a. | |
|
900 Se 5th St Ste 22t Bentonville AR 72712-6090 | |
| (860) 481-7631 | |
| Not Available |
| Full Name | Shannon Candid Arkansas, P.a. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 900 Se 5th St Ste 22t, Bentonville, Arkansas |
| Authorized Official Name and Position | Thomas Shannon (DDS) |
| Authorized Official Contact | 8604817631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Candid Arkansas, P.a. 900 Se 5th St Ste 22t Bentonville AR 72712-6090 Ph: () - | Shannon Candid Arkansas, P.a. 900 Se 5th St Ste 22t Bentonville AR 72712-6090 Ph: (860) 481-7631 |
| NPI Number | 1821605908 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821605908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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