Organization
AT EASE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES TRISTAN RAY HUDSON DDS (OWNER)
(479) 871-4313
Entity
Organization
Contact information
Practice address
701 NW MCNELLY RD STE 13, BENTONVILLE, AR 72712-9160
(479) 553-9225
Mailing address
513 S DODSON RD APT Q4, ROGERS, AR 72758-7318
(479) 871-4313
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2018018775
MO
122300000X
Dentist
Primary
4275
AR
122300000X
Dentist
7052
OK
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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