Individual
DR. CLAYTON L OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1106 S PINE ST, SUITE B, CABOT, AR 72023-3836
(501) 941-1700
(501) 941-1703
Mailing address
1106 SOUTH PINE STREET, SUITE B, CABOT, AR 72023
(501) 941-1700
(501) 941-1703
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3461
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1624816
UNITED CONCORDIA PROVIDER
AR
Enumeration date
07/28/2006
Last updated
07/08/2007
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