Individual
COURTNEY J DONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1 CHILDRENS WAY, SLOT107, LITTLE ROCK, AR 72202-3500
(501) 364-1100
Mailing address
1 CHILDRENS WAY, SLOT107, LITTLE ROCK, AR 72202-3500
(501) 364-1100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3566
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5A001
BLUE CROSS BLUE SHIELD
AR
Enumeration date
01/10/2007
Last updated
12/17/2024
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