Organization
ARKANSAS DENTAL CENTER
Active
Other names
ARKANSAS DENTAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY A. COBB DDS (PRESIDENT)
(501) 847-9191
Entity
Organization
Contact information
Practice address
612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
(501) 847-9191
(501) 847-8337
Mailing address
612 W COMMERCE ST, SUITE ONE, BRYANT, AR 72022-7514
(501) 847-9191
(501) 847-8337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3065
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174534804
NATIONAL PROVIDER IDENTIF
AR
01
—
5T579
ABCBS PROVIDER NUMBER
AR
Enumeration date
06/01/2007
Last updated
06/30/2008
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