Organization
LILLIAM M PRADO DDS
Active
Parent organization
LILLIAM PRADO D.D.S PA
Other names
Faith Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
LILLIAM PRADO D.D.S PA
Authorized official
DR. LILLIAM M PRADO D.D.S (OWNER)
(501) 565-3009
Entity
Organization
Contact information
Practice address
7301 BASELINE RD, LITTLE ROCK, AR 72209-4436
(501) 565-3009
(501) 565-3511
Mailing address
7301 BASELINE RD, LITTLE ROCK, AR 72209-4436
(501) 565-3009
(501) 565-3511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3554
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187151631
—
AR
Enumeration date
08/31/2011
Last updated
08/31/2011
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