# HUMANA DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1962558403
- **Authorized official:** STEVE R ALEXANDER (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (318) 617-8665

## Contact information

- **Practice address:** 4801 CUBA MILLINGTON RD, MILLINGTON, TN 38053-5401
- **Practice address phone:** (318) 617-8665
- **Practice address fax:** (479) 252-6029
- **Mailing address:** PO BOX 1415, GREENWOOD, AR 72936-1415
- **Mailing address phone:** (318) 617-8665
- **Mailing address fax:** (479) 252-6029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 02/21/2012