Individual
FORREST GARNETT BALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
319 S GLENWOOD AVE, RUSSELLVILLE, AR 72801-5906
(479) 968-1334
Mailing address
319 S GLENWOOD AVE, RUSSELLVILLE, AR 72801-5906
(479) 968-1334
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3799
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE00010370
WA
Other
Enumeration date
09/28/2006
Last updated
10/19/2012
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