Individual
DR. ANDREW THOMAS BAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
128 N MOCK ST, PRAIRIE GROVE, AR 72753
(479) 846-3114
Mailing address
PO BOX 913, PRAIRIE GROVE, AR 72753-0913
(479) 846-3114
(479) 846-4144
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2726
AR
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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