Organization
SOUTHERN DENTAL GROUP BALD KNOB, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM REYNOLDS LITTLE D.D.S. (OWNER/DENTIST)
(870) 243-4406
Entity
Organization
Contact information
Practice address
2802 HIGHWAY 367 N, BALD KNOB, AR 72010-3165
(870) 243-4406
Mailing address
PO BOX 17151, JONESBORO, AR 72403-6720
(870) 243-4406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3930
AR
Other
Enumeration date
11/23/2015
Last updated
11/23/2015
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