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Organization

GAVIN TROGDON DDS PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GAVIN TROGDON DDS, PA (OWNER/DENTIST)
(479) 267-5009
Entity
Organization

Contact information

Practice address
181 W MAIN ST, FARMINGTON, AR 72730-2945
(479) 267-5009
(479) 267-5029
Mailing address
181 W MAIN ST, FARMINGTON, AR 72730-2945
(479) 267-5009
(479) 267-5029

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3959
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198735608
AR
Enumeration date
12/03/2014
Last updated
09/22/2020
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