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Organization
ARKANSAS DENTAL CENTER
Active
Organization
ARKANSAS DENTAL CENTER
Active
Other names
ARKANSAS DENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY A. COBB DDS (PRESIDENT)
(501) 847-9191
Entity
Organization
Contact information
Practice address
612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
(501) 847-9191
(501) 847-8337
Mailing address
612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
(501) 847-9191
(501) 847-8337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3065
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174534804
NATIONAL PROVIDER IDENTIF
AR
01
—
5T579
ABCBS PROVIDER NUMBER
AR
Enumeration date
06/01/2007
Last updated
06/30/2008
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