Dds Medical, Pllc | |
2 Saint Vincent Cir Little Rock AR 72205-5423 | |
(501) 626-0053 | |
Not Available |
Full Name | Dds Medical, Pllc |
---|---|
Speciality | Family Medicine |
Location | 2 Saint Vincent Cir, Little Rock, Arkansas |
Authorized Official Name and Position | Sanjay Dass (OWNER) |
Authorized Official Contact | 5016260053 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dds Medical, Pllc 12780 Rivercrest Dr Little Rock AR 72212-1444 Ph: () - | Dds Medical, Pllc 2 Saint Vincent Cir Little Rock AR 72205-5423 Ph: (501) 626-0053 |
NPI Number | 1639690811 |
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Provider Enumeration Date | 06/28/2017 |
Last Update Date | 06/29/2017 |
Medicare PECOS PAC ID | 3173895547 |
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Medicare Enrollment ID | O20170818002331 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639690811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Sanjay R Dass |
---|---|
Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1265497242 PECOS PAC ID: 2163450560 Enrollment ID: I20050727000840 |
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