Organization
DARDANELLE FAMILY DENTISTRY
Active
Other names
Dardanelle Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE ELIZABETH CROW-GOATES DDS, PLLC (OWNER)
(479) 229-3891
Entity
Organization
Contact information
Practice address
2533 STATE HIGHWAY 22 W, DARDANELLE, AR 72834-8831
(479) 229-3891
Mailing address
PO BOX 447, DARDANELLE, AR 72834-0447
(479) 229-3891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4037
ASBDE LICENSE
AR
Enumeration date
06/04/2015
Last updated
08/31/2020
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