| Tmj And Facial Pain Center,llc | |
|
2600 Browns Lane Ste B Jonesboro AR 72404 | |
| (870) 932-7000 | |
| (870) 932-1650 |
| Full Name | Tmj And Facial Pain Center,llc |
|---|---|
| Speciality | Dentist |
| Location | 2600 Browns Lane, Jonesboro, Arkansas |
| Authorized Official Name and Position | Heather Bond Southard (OWNER) |
| Authorized Official Contact | 8709327000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tmj And Facial Pain Center,llc 2600 Browns Lane Ste B Jonesboro AR 72404 Ph: (870) 932-7000 | Tmj And Facial Pain Center,llc 2600 Browns Lane Ste B Jonesboro AR 72404 Ph: (870) 932-7000 |
| NPI Number | 1922476571 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 12/20/2023 |
| Medicare PECOS PAC ID | 7416259916 |
|---|---|
| Medicare Enrollment ID | O20151230000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922476571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3469 (Arkansas) | Primary |
| Provider Name | Heather Bond Southard |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376616664 PECOS PAC ID: 9335364702 Enrollment ID: I20160104001388 |
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