Organization
ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A.
Active
Parent organization
ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A.
Other names
Woodland Heights family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A.
Authorized official
KIM WILSON (CRED SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
3801 WOODLAND HEIGHTS RD STE 175, LITTLE ROCK, AR 72212-2481
(501) 224-1004
Mailing address
3801 WOODLAND HEIGHTS RD STE 175, LITTLE ROCK, AR 72212-2481
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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