# RONNIE L FAULKNER, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912500364
- **Authorized official:** RONNIE LEE FAULKNER DDS (PRESIDE)
- **Authorized official phone:** (501) 276-3432

## Contact information

- **Practice address:** 138 HIGHWAY 270 E, MOUNT IDA, AR 71957-9409
- **Practice address phone:** (870) 867-3432
- **Practice address fax:** (870) 867-3783
- **Mailing address:** PO BOX 901, MOUNT IDA, AR 71957-0901
- **Mailing address phone:** (870) 867-3432
- **Mailing address fax:** (870) 867-3783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2020
- **Last updated:** 11/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 111161608 | — | AR |