# BRIEN S DOUGLAS DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417109570
- **Authorized official:** DR. BRIEN S DOUGLAS DDS (PRESIDENT)
- **Authorized official phone:** (501) 623-9882

## Contact information

- **Practice address:** 2212 MALVERN AVE, SUITE 10, HOT SPRINGS, AR 71901-8038
- **Practice address phone:** (501) 623-9882
- **Practice address fax:** (501) 623-8424
- **Mailing address:** 2212 MALVERN AVE, SUITE 10, HOT SPRINGS, AR 71901-8038
- **Mailing address phone:** (501) 623-9882
- **Mailing address fax:** (501) 623-8424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3372 | AR | Yes |

## Other

- **Enumeration date:** 10/21/2008
- **Last updated:** 10/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 145104608 | — | AR |