Individual
DR. DJUANA LEIGH CARTILLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4941 NORTH WASHINGTON/HIGHWAY1, FORREST CITY, AR 72335
(870) 630-1500
(870) 630-6405
Mailing address
4941 NORTH WASHINGTON/HIGHWAY 1, FORREST CITY, AR 72335
(870) 630-1500
(870) 630-6405
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3045
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123626608
—
AR
01
—
59632
BCBS PROVIDER #
AR
01
—
710851189
TAX IDENTIFICATION NUMBER
AR
01
—
862131
UNITED CONCORDIA NUMBER
AR
Enumeration date
11/22/2006
Last updated
08/28/2007
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