Organization
ARKANSAS DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE SECREASE RDA CDA (OFFICE MANAGER)
(870) 932-0330
Entity
Organization
Contact information
Practice address
3409 GATEWAY COVE, JONESBORO, AR 72404
(870) 336-0543
Mailing address
3409 GATEWAY COVE, JONESBORO, AR 72404
(870) 336-0543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2621
AR
Other
Enumeration date
05/13/2008
Last updated
06/10/2008
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