Organization
AUSTIN FAMILY DENTISTY OF LITTLE ROCK
Active
Parent organization
AUSTIN FAMILY DENTISTRY
Organization subpart
Yes
Provider details
NPI number
Legal business name
AUSTIN FAMILY DENTISTRY
Authorized official
DR. BRYAN ANTHONY AUSTIN DDS (OWNER)
(501) 223-9489
Entity
Organization
Contact information
Practice address
11211 CANTRELL RD, STE 200, LITTLE ROCK, AR 72212-1819
(501) 223-9489
Mailing address
11211 CANTRELL RD, STE 200, LITTLE ROCK, AR 72212-1819
(501) 223-9489
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3057
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6869920001
MEDICARE PTAN
AR
Enumeration date
01/22/2014
Last updated
01/22/2014
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