Organization
PRAIRIE GROVE DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN DOUGLAS CLARK DDS (DENTIST-OWNER)
(479) 244-2052
Entity
Organization
Contact information
Practice address
1121 E HERITAGE PKWY, PRAIRIE GROVE, AR 72753-6013
(479) 244-2052
(479) 846-1940
Mailing address
1121 E HERITAGE PKWY, PRAIRIE GROVE, AR 72753-6013
(479) 244-2052
(479) 846-1940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/05/2021
Last updated
01/05/2021
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