Organization
RICKY L PRICE DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY PRICE DDS (OWNER)
(870) 238-9190
Entity
Organization
Contact information
Practice address
311 MERRIMAN AVE E, WYNNE, AR 72396-2945
(870) 238-9190
Mailing address
311 MERRIMAN AVE E, WYNNE, AR 72396-2945
(870) 238-9190
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2801
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110222
UNITED CONCORDIA
AR
01
—
58029
BLUE CROSS BLUE SHEILD
AR
Enumeration date
07/28/2006
Last updated
08/22/2020
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