Individual
DR. KATHLEEN GOOD EDERLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
413 N. UNIVERSITY AVE., LITTLE ROCK, AR 72205
(501) 664-6040
(501) 537-0479
Mailing address
413 N. UNIVERSITY AVE., LITTLE ROCK, AR 72205
(501) 664-6040
(501) 537-0479
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2739
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
BCBS OF TN
AR
Enumeration date
10/12/2012
Last updated
10/12/2012
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