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Organization

MICHAEL S DALTON DDS PA

Active
Other names
Dalton Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PAM D FROST (OFFICE COORDINATOR)
(479) 968-1001
Entity
Organization

Contact information

Practice address
3105 W MAIN ST, RUSSELLVILLE, AR 72801-2454
(459) 968-1001
Mailing address
3105 W MAIN ST, RUSSELLVILLE, AR 72801-2454
(459) 968-1001

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3117
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162329631
AR
Enumeration date
05/08/2007
Last updated
06/12/2008
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