INTERDISCIPLINARY DENTAL THERAPY P.A. NPI 1992042386

NPI Information

INTERDISCIPLINARY DENTAL THERAPY, P.A. is a general practice dentist in Little Rock, 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. INTERDISCIPLINARY DENTAL THERAPY, P.A. NPI is 1992042386. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

9200 CHICOT RD
LITTLE ROCK, AR
ZIP 72209-107
Phone: (501) 562-3029
Fax: (501) 568-1823

The provider's authorized official is Montgomery Dwight Heathman .
The authorized official title is President/ceo and has the following contact phone number (479) 856-5588.

The enumeration date for this NPI number is 1/6/2013 and was last updated on 1/6/2013.

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:

Other Identifiers

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

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