Individual
HARRISON JAKE WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
805 N 20TH PL STE 2, ROGERS, AR 72756-3571
(479) 986-0905
(479) 986-0905
Mailing address
805 N 20TH PL STE 2, ROGERS, AR 72756-3571
(479) 986-0905
(479) 986-0905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4745
AR
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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