Organization
AMD FAMILY DENTISTRY
Active
Other names
AMD Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DAVIS DDS (OWNER)
(870) 732-2107
Entity
Organization
Contact information
Practice address
306 N 6TH ST, WEST MEMPHIS, AR 72301-3221
(870) 732-2107
Mailing address
PO BOX 2225, WEST MEMPHIS, AR 72303-2225
(870) 732-2107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160686608
—
AR
Enumeration date
06/10/2021
Last updated
06/10/2021
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