Organization
JIM BLANCHARD DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIM BLANCHARD DDS (PRESIDENT)
(870) 423-6963
Entity
Organization
Contact information
Practice address
201 RICE ST, BERRYVILLE, AR 72616-4388
(870) 423-6963
(870) 423-2109
Mailing address
201 RICE ST, BERRYVILLE, AR 72616-4388
(870) 423-6963
(870) 423-2109
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2381
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104808608
—
AR
Enumeration date
03/18/2014
Last updated
03/18/2014
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