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Organization

MARKHAM STREET DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT LEE JOLLY SR. DR (PRESIDENT)
(501) 352-6580
Entity
Organization

Contact information

Practice address
10220 W MARKHAM ST, SUITE 101, LITTLE ROCK, AR 72205-2189
(501) 666-7602
Mailing address
10220 W MARKHAM ST, SUITE 101, LITTLE ROCK, AR 72205-2184
(501) 666-7602

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
07/09/2012
Last updated
07/09/2012
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