Individual
DR. MICHAEL T HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3710 E. MAIN, SUITE K, BLYTHEVILLE, AR 72315
(870) 762-1331
Mailing address
3710 E. MAIN, SUITE K, BLYTHEVILLE, AR 72315
(870) 762-1331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3393
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407476
UNITED CONCORDIA NUMBER
—
01
—
5Y912
BCBS ID NUMBER
AR
Enumeration date
03/26/2007
Last updated
07/09/2007
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