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Individual

RONNIE LEE FAULKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
138 HWY 270 EAST, MOUNT IDA, AR 71957-0901
(870) 867-3432
(870) 867-3783
Mailing address
PO BOX 901, MOUNT IDA, AR 71957-0901
(870) 867-3432
(870) 867-3783

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2688
AR

Other

Enumeration date
12/19/2006
Last updated
07/08/2007
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