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Organization
HIGGINBOTHAM DENTAL GROUP, PLLC
Active
Organization
HIGGINBOTHAM DENTAL GROUP, PLLC
Active
Other names
Higginbotham Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MISTI ROSS (INSURANCE DIRECTOR)
(870) 336-3732
Entity
Organization
Contact information
Practice address
113 HARBOR TOWN SQ STE 203, MEMPHIS, TN 38103-8890
(901) 453-6081
(901) 453-6083
Mailing address
1804 OLD GREENSBORO RD BLDG B, JONESBORO, AR 72405-0003
(870) 336-5620
(870) 336-3810
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10169
TN
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/07/2016
Last updated
04/09/2024
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