Organization
SANDERS, TOMPKINS, SCHIRO, LANDERS AND SANDERS PLLC
Active
Other names
Pediatric Dental Associates and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ROCIO RODRIGUEZ (HUMAN RESOURCES COORDINATOR)
(479) 582-0600
Entity
Organization
Contact information
Practice address
1607 E RAINFOREST DR, FAYETTEVILLE, AR 72703-5385
(479) 582-0600
(479) 443-4630
Mailing address
1607 E RAINFOREST DR, FAYETTEVILLE, AR 72703-5385
(479) 582-0600
(479) 443-4630
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1400699
UCCI/US ABLE PROVIDER
AR
05
—
157248631
—
AR
01
—
414939
BCBS OF KS
KS
01
—
5C635
BCBS,HEALTH ADVANTAGE
AR
Enumeration date
10/16/2006
Last updated
06/12/2024
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