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CONWAY REGIONAL MEDICAL CENTER INC NPI 1043864093


NPI Information

NPI: 1043864093
Provider Name: CONWAY REGIONAL MEDICAL CENTER, INC

Doing Business As: CONWAY REGIONAL INTERFAITH DENTAL CLINIC

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 04D1051461

Address:
830 N CREEK DR
CONWAY, AR
ZIP 72032
Phone: (501) 932-0559
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CONWAY REGIONAL MEDICAL CENTER, INC is a general practice dentist in Conway, AR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CONWAY REGIONAL MEDICAL CENTER, INC NPI is 1043864093. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Conway Regional Interfaith Dental Clinic.

The provider's business location address is:

830 N CREEK DR
CONWAY, AR
ZIP 72032-711
Phone: (501) 932-0559
Fax: (501) 205-1983

The provider's authorized official is William Pack .
The authorized official title is Cfo and has the following contact phone number (501) 450-2112.

The CLIA number assigned to this NPI record is 04D1051461 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2019 and was last updated on 11/9/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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