Organization
AUSTIN FAMILY DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN A AUSTIN DDS (OWNER PRES)
(501) 851-3262
Entity
Organization
Contact information
Practice address
3201 CLUB MANOR, SUITE A, MAUMELLE, AR 72113
(501) 851-3262
(501) 851-3766
Mailing address
3201 CLUB MANOR, SUITE A, MAUMELLE, AR 72113
(501) 851-3262
(501) 851-3766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
AR3057
AR
122300000X
Dentist
Primary
AR3521
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871870
UCCI DR CLINT FULKS
—
01
—
58662
BCBS
AR
01
—
828326
UCCI DR BRYAN A AUSTIN
—
Enumeration date
10/25/2006
Last updated
05/06/2013
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