Individual
KARLA KAY GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
802 N DIXIELAND RD, ROGERS, AR 72756
(479) 936-8800
(479) 936-8808
Mailing address
802 N DIXIELAND RD, ROGERS, AR 72756
(479) 936-8800
(479) 936-8808
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3098
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109051
UNITED CONCORDIA
AR
05
—
125300608
—
AR
01
—
3098
DENTAL LICENSE NUMBER
AR
01
—
59982
BCBS
AR
Enumeration date
07/31/2006
Last updated
06/03/2020
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