# ARKANSAS DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ARKANSAS DENTAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417159427
- **Authorized official:** MR. ANDY A. COBB DDS (PRESIDENT)
- **Authorized official phone:** (501) 847-9191

## Contact information

- **Practice address:** 612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
- **Practice address phone:** (501) 847-9191
- **Practice address fax:** (501) 847-8337
- **Mailing address:** 612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
- **Mailing address phone:** (501) 847-9191
- **Mailing address fax:** (501) 847-8337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3065 | AR | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1174534804 | NATIONAL PROVIDER IDENTIF | AR |
| 01 | — | 5T579 | ABCBS PROVIDER NUMBER | AR |