Organization
ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A
Active
Other names
Arkadelphia Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH FISH (CREDENTIALING COORDINATOR)
(217) 540-5699
Entity
Organization
Contact information
Practice address
3003 TWIN RIVERS DR, ARKADELPHIA, AR 71923-4219
(870) 246-2242
(870) 246-2495
Mailing address
3003 TWIN RIVERS DR, ARKADELPHIA, AR 71923-4219
(870) 246-2242
(870) 246-2495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2256
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172175631
—
AR
Enumeration date
11/24/2008
Last updated
05/10/2019
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