| Star City Community Dental | |
|
557 Kirkwood Rd Star City AR 71667-8843 | |
| (870) 628-5110 | |
| (855) 854-6281 |
| Full Name | Star City Community Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 557 Kirkwood Rd, Star City, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star City Community Dental Po Box 509 Dermott AR 71638-0509 Ph: (870) 538-5414 | Star City Community Dental 557 Kirkwood Rd Star City AR 71667-8843 Ph: (870) 628-5110 |
| NPI Number | 1649679051 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 07/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649679051 | NPI | - | NPPES |
| 205925631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Star City High School Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 E Arkansas St, Star City, AR 71667 Phone: 870-628-5110 Fax: 855-854-6281 | |
Star City Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 W Bradley St, Star City, AR 71667 Phone: 870-628-5131 | |
Jimmy Brown Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Ashley St., Star City, AR 71667 Phone: 650-419-2545 Fax: 855-854-6281 |