Organization
WEEKEND DENTAL CLINIC
Active
Other names
Charles G. Liggett, Jr. DDS, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES GREGORY LIGGETT JR. DDS (OWNER)
(479) 719-0753
Entity
Organization
Contact information
Practice address
5111 ROGERS AVE, SUITE 207, FORT SMITH, AR 72903-2047
(479) 719-0753
Mailing address
3200 ROGERS AVE, SUITE 111, FORT SMITH, AR 72903-2954
(479) 782-0080
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3478
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152884608
—
AR
Enumeration date
11/19/2008
Last updated
11/19/2008
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