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Individual

DR. GERALD WILLIAM FRIEND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS MS

Contact information

Practice address
2700 ALLYSON LANE, CONWAY, AR 72034
(501) 730-0375
(501) 730-0335
Mailing address
PO BOX 11020, CONWAY, AR 72033-0018
(501) 730-0375

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2793
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58600
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/14/2006
Last updated
07/08/2007
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