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Organization
WASHINGTON REGIONAL MEDICAL CENTER
Active
Organization
WASHINGTON REGIONAL MEDICAL CENTER
Active
Other names
Washington Regiona Medical Center Mobile Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM L BRADLEY (CEO)
(469) 463-1000
Entity
Organization
Contact information
Practice address
12 E APPLEBY RD, SUITE 102, FAYETTEVILLE, AR 72703-3901
(479) 463-4746
(479) 463-7864
Mailing address
12 E APPLEBY RD, SUITE 102, FAYETTEVILLE, AR 72703-3901
(479) 463-4746
(479) 463-7864
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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