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112 W Bradley St Star City AR 71667-5114 | |
(870) 628-5131 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 112 W Bradley St, Star City, Arkansas |
Authorized Official Name and Position | Chad D Matone (OWNER/DENTIST) |
Authorized Official Contact | 5012051084 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 241785 Little Rock AR 72223-0014 Ph: (501) 205-1084 | 112 W Bradley St Star City AR 71667-5114 Ph: (870) 628-5131 |
NPI Number | 1578079307 |
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Provider Enumeration Date | 12/15/2017 |
Last Update Date | 02/15/2019 |
Identifier | Type | State | Issuer |
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1578079307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |