Individual
DR. WADE KIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1845 N GREEN ACRES RD, FAYETTEVILLE, AR 72703-2615
(479) 521-2112
Mailing address
1845 N GREEN ACRES RD, FAYETTEVILLE, AR 72703-2615
(479) 521-2112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3468
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3468
DELTA INS, AND LICENSE #
—
01
—
5 Y 371
BCBS
—
Enumeration date
01/09/2007
Last updated
07/08/2007
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