Individual
DR. CASEY DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3920 W WALNUT ST, ROGERS, AR 72756-1809
(885) 993-5543
Mailing address
6515 W PLEASANT WAY, ROGERS, AR 72758-8427
(972) 415-9308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4269
AR
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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