Individual
CHARLES ED KNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9601 LILE DR STE 240, LITTLE ROCK, AR 72205-6342
(501) 224-3008
(501) 224-3009
Mailing address
9601 LILE DR STE 240, LITTLE ROCK, AR 72205-6342
(501) 224-3008
(501) 224-3009
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2163
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15086000040
QUAL CHOICE PROVIDER #
AR
01
—
56262
BLUE CROSS PROVIDER #
AR
Enumeration date
08/29/2006
Last updated
07/09/2007
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