Individual
DR. KOHL BLICKENSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
710 MARION ST STE 302, SEARCY, AR 72143-4880
(501) 268-3666
Mailing address
106 RIVER OAKS BLVD, SEARCY, AR 72143-4500
(501) 827-6535
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4763
AR
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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