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ARKANSAS ORAL SURGERY NPI 1962939439


NPI Information

NPI: 1962939439
Provider Name: ARKANSAS ORAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 04D2090186

Address:
2425 PRINCE ST STE 2
CONWAY, AR
ZIP 72034
Phone: (501) 329-3223
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ARKANSAS ORAL SURGERY is an oral and maxillofacial surgery dentist in Conway, AR. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ARKANSAS ORAL SURGERY NPI is 1962939439. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2425 PRINCE ST STE 2
CONWAY, AR
ZIP 72034-701
Phone: (501) 329-3223
Fax: (501) 329-8939

The provider's authorized official is Donny L Quick .
The authorized official title is Owner and has the following contact phone number (501) 329-3223.

The CLIA number assigned to this NPI record is 04D2090186 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/16/2017 and was last updated on 5/16/2017.


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
11223S0112XDentistOral and Maxillofacial Surgery3342ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1165772679MEDICAIDARKANSAS

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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