Individual
DR. MIRANDA MICHELLE CHILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
312 PROFESSIONAL PARK DR, SUITE D, ARKADELPHIA, AR 71923-5315
(870) 245-2323
(270) 245-2368
Mailing address
312 PROFESSIONAL PARK DR, SUITE D, ARKADELPHIA, AR 71923-5315
(870) 245-2323
(270) 245-2368
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3103
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U242
BLUE CROSS BLUE SHIELD PR
AR
01
—
766360
UNITED CONCORDIA
AR
Enumeration date
08/20/2006
Last updated
07/08/2007
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