Organization
ASCENSION DEPAUL SERVICES
Active
Parent organization
ASCENSION DEPAUL SERVICES
Other names
Ascension DePaul Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION DEPAUL SERVICES
Authorized official
LISA GOODGAME (CFO)
(870) 382-3080
Entity
Organization
Contact information
Practice address
407 SOUTH GOULD AVE, GOULD, AR 71643
(870) 263-4317
(870) 263-4782
Mailing address
PO BOX 158, DUMAS, AR 71639-0158
(870) 382-3080
(870) 382-3085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149324631
—
AR
Enumeration date
04/17/2007
Last updated
03/31/2021
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