Organization
PEDIATRICS PLUS DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DENTON (OWNER)
(501) 329-5459
Entity
Organization
Contact information
Practice address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176368744
—
AR
Enumeration date
06/19/2009
Last updated
06/19/2009
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