Organization
SPADES DENTAL CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM AUSTIN SPADES D.D.S. (OWNER/DENTIST)
(870) 910-0000
Entity
Organization
Contact information
Practice address
900 SOUTHWEST DR, STE C&D, JONESBORO, AR 72401-7051
(870) 910-0000
(870) 910-3500
Mailing address
900 SOUTHWEST DR, STE C&D, JONESBORO, AR 72401-7051
(870) 910-0000
(870) 910-3500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3299
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136699608
—
AR
01
—
5U366
ARKANSAS BLUE CROSS AND BLUE SHIELD
AR
Enumeration date
04/28/2008
Last updated
04/28/2008
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