Organization
WOOD DENTAL GROUP, P.A.
Active
Other names
Wood & Cook Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES S WOOD JR. D.D.S. (OWNER)
(870) 735-3601
Entity
Organization
Contact information
Practice address
715 CALVIN AVERY, WEST MEMPHIS, AR 72301
(870) 735-3601
(870) 732-9535
Mailing address
715 CALVIN AVERY DR, WEST MEMPHIS, AR 72301
(870) 735-3601
(870) 732-9535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101993608
—
AR
Enumeration date
09/15/2006
Last updated
10/01/2020
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