| NPI Details | |
|---|---|
| NPI | 1053531319 |
| Enumeration Date | 04/27/2007 |
| Last Updated | 07/08/2007 |
| Entity Type | Healthcare Provider |
| Active | Over 11 years ago |
| Authorized Information | |
|---|---|
| Name | TIFFANY DIANE TIFFANY |
| Position | OFFICE MANAGER |
| Phone | (870) 238-3628 |
| Fax | (870) 238-0757 |
| Practice Location | |
|---|---|
| 715 EAST ELDRDIGE AVENUE WYNNE AR, 72396, US |
|
| Phone | (870) 238-3628 |
| Fax | (870) 238-0757 |
| Business Location | |
|---|---|
| P.O. BOX 368 WYNNE AR, 72396-0368, US |
|
| Phone | (870) 238-3628 |
| Fax | (870) 238-0757 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 122300000X |
| License State | Arkansas |
| License Number | 2218 |
| Remove 1053531319 NPI Number | |
According to our database, George Scott Puryear, Dds, Pa NPI is 1053531319, taxonomy code is 122300000X and license number is 2218, license state is located at Arkansas. George Scott Puryear, Dds, Pa physically located at 715 East Eldrdige Avenue, Wynne AR, 72396. NPI Number 1033115704 has the healthcare provider type.
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1053531319 NPI number is provided on an as is basis without warranty of any kind. 1053531319 is maintained by the National Plan & Provider Enumeration System. The contents of George Scott Puryear, Dds, Pa are for informational purposes only.
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