Organization
TERRY G BOX DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY R BRIDGES (OFFICE MANAGER)
(479) 521-4822
Entity
Organization
Contact information
Practice address
2101 N GREEN ACRES RD, FAYETTEVILLE, AR 72703-2808
(479) 521-4822
(479) 521-5477
Mailing address
2101 N GREEN ACRES RD, FAYETTEVILLE, AR 72703-2808
(479) 521-4822
(479) 521-5477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2180
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023032802
NPI
AR
Enumeration date
04/26/2016
Last updated
04/26/2016
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