| Warren Dental Clinic | |
|
800 N Walnut St Warren AR 71671-2009 | |
| (870) 466-8450 | |
| (870) 226-5101 |
| Full Name | Warren Dental Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 N Walnut St, Warren, Arkansas |
| Authorized Official Name and Position | Gary Allan Nichols (CEO) |
| Authorized Official Contact | 8709423000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Dental Clinic Po Box 509 Dermott AR 71638-0509 Ph: (870) 942-3000 | Warren Dental Clinic 800 N Walnut St Warren AR 71671-2009 Ph: (870) 466-8450 |
| NPI Number | 1407510720 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 07/11/2024 |
| Medicare PECOS PAC ID | 5193785590 |
|---|---|
| Medicare Enrollment ID | O20220104001714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407510720 | NPI | - | NPPES |
| 280277631 | 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 |
Mainline Health Systems, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2018 Lady Jack Drive, Warren, AR 71638 Phone: 870-466-8450 Fax: 877-456-0923 | |
Donnie R. Bryant, Dds, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 W Church St, Warren, AR 71671 Phone: 870-226-6556 Fax: 870-226-6150 |