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Organization

SOVEREIGN FORCE, PA

Active
Other names
The Clinic at Commerce Centre
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AJDAHAN D. BICAK M.D. (PRESIDENT)
(479) 586-9800
Entity
Organization

Contact information

Practice address
301 SW 16TH ST, BENTONVILLE, AR 72712-7173
(479) 586-9800
Mailing address
301 SW 16TH ST, BENTONVILLE, AR 72712-7173
(479) 586-9800

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MC-2586
AR

Other

Enumeration date
12/28/2007
Last updated
12/28/2007
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