Individual
IYAMILET VARGAS ALVAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3500 BLACK FOREST DR # 1, FAYETTEVILLE, AR 72704-6551
(479) 888-5119
Mailing address
3539 W EARNHARDT DR, FAYETTEVILLE, AR 72704-6091
(305) 896-4642
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4772
AR
1223P0221X
Pediatric Dentistry
4772
AR
1223P0300X
Periodontics
4772
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4772
AR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4772
AR
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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