Organization
WASHINGTON REGIONAL MEDICAL CENTER
Active
Other names
Washington Regiona Medical Center Mobile Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM L BRADLEY (CEO)
(469) 463-1000
Entity
Organization
Contact information
Practice address
12 E APPLEBY RD, SUITE 102, FAYETTEVILLE, AR 72703-3901
(479) 463-4746
(479) 463-7864
Mailing address
12 E APPLEBY RD, SUITE 102, FAYETTEVILLE, AR 72703-3901
(479) 463-4746
(479) 463-7864
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/03/2014
Last updated
11/03/2014
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