Organization
GARRY L. HARGIS, D.D.S., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRY L. HARGIS D.D.S. (PRESIDENT)
(501) 562-5183
Entity
Organization
Contact information
Practice address
8211 GEYER SPRINGS RD, SUITE P-4, LITTLE ROCK, AR 72209-4952
(501) 562-5183
Mailing address
8211 GEYER SPRINGS RD, SUITE P-4, LITTLE ROCK, AR 72209-4952
(501) 562-5183
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
106
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58280
BLUE CROSS BLUE SHIELD
AR
01
—
785774
UNITED CONCARDIA
PA
Enumeration date
09/02/2006
Last updated
08/22/2020
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