Organization
ORAL SURGERY OF CENTRAL ARKANSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M JOHNSON DDS (PRESIDENT)
(501) 327-5255
Entity
Organization
Contact information
Practice address
707 PARKWAY ST STE 103, CONWAY, AR 72034-5363
(501) 327-5255
Mailing address
707 PARKWAY ST STE 103, CONWAY, AR 72034-5363
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
3775
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202575679
—
AR
Enumeration date
10/26/2015
Last updated
10/26/2015
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