Individual
JOHN DOUGLAS PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 S BOWMAN RD STE 1, LITTLE ROCK, AR 72211-3710
(501) 222-9101
Mailing address
11324 ROCKY VALLEY DR, LITTLE ROCK, AR 72212-3032
(501) 831-1140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4235
AR
1223P0221X
Pediatric Dentistry
Primary
4235
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2017
Last updated
07/24/2019
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