Individual
MR. ERIC KAMAAL MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
26 GREEN VALLEY DR, MOUNTAIN HOME, AR 72653-8102
(870) 425-6911
(870) 424-4891
Mailing address
26 GREEN VALLEY DR, MOUNTAIN HOME, AR 72653-8102
(870) 425-6911
(870) 424-4891
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2880
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58313
BLUE CROSS BLUE SHIELD
AR
01
—
842508
UNITED CONCORDIA
AR
Enumeration date
10/27/2006
Last updated
07/08/2007
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