Organization
AXPM ORAL SURGERY PLLC
Active
Parent organization
MARK L. DAKE, DDS, MSD AND BRYAN C. HILLER, DMD, MS ORTHODONTIC ASSOCI
Other names
Impact Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARK L. DAKE, DDS, MSD AND BRYAN C. HILLER, DMD, MS ORTHODONTIC ASSOCI
Authorized official
DR. BRYAN HILLER DDS, MS (MANAGER)
(501) 781-2777
Entity
Organization
Contact information
Practice address
2305 SPRINGHILL RD, SUITE 1, BRYANT, AR 72019-7552
(501) 408-4774
Mailing address
5100 TALLEY RD, SUITE 100, LITTLE ROCK, AR 72204-8032
(501) 781-2777
(501) 781-2778
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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