Ford Dental Care

NPI 1124182142 - Dentist - 1223G0001X

NPI Details
NPI 1124182142
Enumeration Date 12/21/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JERRY DEREK JERRY
Position PRESIDENT
Phone (479) 736-8789
Fax (479) 736-5011
Practice Location
125 N RUST AVE
GENTRY AR, 72734, US
Phone (479) 736-8789
Fax (479) 736-5011
Business Location
125 N RUST AVE
GENTRY AR, 72734, US
Phone (479) 736-8789
Fax (479) 736-5011
Toxanomy
Taxonomy Code 1223G0001X
License State Arkansas
License Number 3095
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According to our database, Ford Dental Care NPI is 1124182142, taxonomy code is 1223G0001X and license number is 3095, license state is located at Arkansas. Ford Dental Care physically located at 125 N Rust Ave, Gentry AR, 72734. NPI Number 1033115704 has the healthcare provider type.

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1124182142 NPI number is provided on an as is basis without warranty of any kind. 1124182142 is maintained by the National Plan & Provider Enumeration System. The contents of Ford Dental Care are for informational purposes only.