Organization
HIGGINBOTHAM DENTAL GROUP, PLLC
Active
Other names
Higginbotham Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MISTI ROSS (INS DIRECTOR)
(870) 336-3732
Entity
Organization
Contact information
Practice address
3922 E MAIN ST STE D, BLYTHEVILLE, AR 72315-6813
(870) 762-1331
Mailing address
1804 OLD GREENSBORO RD BLDG B, JONESBORO, AR 72405-0003
(870) 336-3732
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3393
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160743631
—
AR
Enumeration date
03/26/2007
Last updated
10/14/2020
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