Individual
DR. JASON SCOTT HAVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2700 ALLYSON LANE, CONWAY, AR 72034
(501) 730-0375
(501) 730-0335
Mailing address
PO BOX 11020, CONWAY, AR 72033-0018
(501) 730-0375
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3475
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152983608
—
AR
01
—
5X909
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/14/2006
Last updated
12/16/2011
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