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Organization
CRAWFORD-SEBASTIAN COMMUNITY DEVELOPMENT
Active
Organization
CRAWFORD-SEBASTIAN COMMUNITY DEVELOPMENT
Active
Parent organization
CRAWFORD-SEBASTIAN COMMUNITY DEVELOPMENT COUNCIL, INC.
Other names
Community Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRAWFORD-SEBASTIAN COMMUNITY DEVELOPMENT COUNCIL, INC.
Authorized official
MR. MARK WHITMER (EXECUTIVE DIRECTOR)
(479) 785-2303
Entity
Organization
Contact information
Practice address
109 NO. 17TH, FORT SMITH, AR 72901
(479) 782-6021
(479) 709-0161
Mailing address
PO BOX 4069, FORT SMITH, AR 72914-4069
(479) 785-2303
(479) 785-2341
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
AR
302R00000X
Health Maintenance Organization
101872002
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101872002
—
AR
Enumeration date
04/19/2007
Last updated
10/16/2009
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