Organization
PINNACLE PERIODONTICS
Active
Other names
Pinnacle Periodontics & Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW D CARLISLE D.D.S., M.S. (OWNER/PERIODONTIST)
(501) 225-4644
Entity
Organization
Contact information
Practice address
1225 BRECKENRIDGE DR, #110, LITTLE ROCK, AR 72205-1558
(501) 225-4644
(501) 225-4102
Mailing address
1225 BRECKENRIDGE DR, #110, LITTLE ROCK, AR 72205-1558
(501) 225-4644
(501) 225-4102
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3613
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195700679
—
AR
Enumeration date
04/23/2013
Last updated
04/23/2013
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