Individual
VAN MICHAEL MCQUEEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
640 N GARLAND AVE # 104, FAYETTEVILLE, AR 72701
(479) 521-2653
Mailing address
640 N GARLAND AVE # 104, FAYETTEVILLE, AR 72701-3116
(479) 521-2653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4178
AR
Other
Enumeration date
06/06/2017
Last updated
07/05/2018
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