Organization
B.W. PETKOVICH, D.D.S., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD WILLIAM PETKOVICH D.D.S. (DENTIST)
(870) 425-9757
Entity
Organization
Contact information
Practice address
500 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2913
(870) 425-9757
Mailing address
500 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2913
(870) 425-9757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2371
AR
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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