Individual
DR. DAVID WAYNE VANWINKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
309 MORROW ST S, SUITE A, MENA, AR 71953-2502
(479) 394-6596
(479) 394-6647
Mailing address
PO BOX 458, MENA, AR 71953-0458
(479) 394-6596
(479) 394-6647
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2836
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58062
BLUE CROSS BLUE SHIELD
AR
01
—
855971
UNITED CONCORDIA
AR
Enumeration date
04/11/2007
Last updated
09/26/2007
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