Organization
SOUTHERN DENTAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM REYNOLDS LITTLE D.D.S. (OWNER)
(870) 243-4406
Entity
Organization
Contact information
Practice address
2100 KILLOUGH RD N, WYNNE, AR 72396-1009
(870) 243-4406
Mailing address
PO BOX 17151, JONESBORO, AR 72403-6720
(870) 243-4406
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3930
AR
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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