CHILDRENS DENTAL CLINIC OF JONESBORO NPI 1013479104

NPI Information

CHILDRENS DENTAL CLINIC OF JONESBORO is a dental clinic center in Jonesboro, AR. CHILDRENS DENTAL CLINIC OF JONESBORO NPI is 1013479104. The provider is registered as an organization entity type.

The provider's business location address is:

217 E CHERRY AVE
JONESBORO, AR
ZIP 72401-372
Phone: (870) 897-2489

The provider's authorized official is Lauren Lee .
The authorized official title is Office Manager and has the following contact phone number (870) 897-9465.

The CLIA number assigned to this NPI record is 04D0467944 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/5/2019 and was last updated on 4/5/2019.

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:

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