Individual
AIXA JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 W WALNUT ST, ROGERS, AR 72756-3243
(479) 636-6807
Mailing address
5381 LITTLE FIELD AVE, SPRINGDALE, AR 72762-3244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4765
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2024
Last updated
07/20/2024
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