Individual
CHARLES KEMP CHILDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
143 HWY 463 N, TRUMANN, AR 72472
(870) 483-7654
(870) 486-7047
Mailing address
143 HWY 463 N, TRUMANN, AR 72472
(870) 483-7654
(870) 486-7047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2610
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58751
BCBS
AR
01
—
595995
UNITED CONCORDIA
—
Enumeration date
08/20/2006
Last updated
07/08/2007
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