Organization
BLAYNE TIPTON DDS PA
Active
Other names
Tipton Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
BLAYNE H TIPTON DDS (PRESIDENT)
(501) 520-5437
Entity
Organization
Contact information
Practice address
307 G CARPENTER DAM ROAD, HOT SPRINGS, AR 71901
(501) 520-5437
(501) 520-5433
Mailing address
307 G CARPENTER DAM ROAD, HOT SPRINGS, AR 71901
(501) 520-5437
(501) 520-5433
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154429608
—
AR
05
—
171064631
—
AR
Enumeration date
09/19/2008
Last updated
11/22/2017
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