# FULL THROTTLE DENTAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Higginbotham Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336875558
- **Authorized official:** MISTI ROSS (INSURANCE DIRECTOR)
- **Authorized official phone:** (870) 336-3732

## Contact information

- **Practice address:** 6630 SUMMER KNOLL CIR STE 103, BARTLETT, TN 38134-2926
- **Practice address phone:** (901) 377-5060
- **Mailing address:** 1804 OLD GREENSBORO RD BLDG B, JONESBORO, AR 72405-0003
- **Mailing address phone:** (870) 336-3732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 09/27/2022