Organization
AXPM JONESBORO PEDO, PLLC
Active
Other names
Leap Kids Dental- Jonesboro
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DAKE (OWNER)
(501) 781-2777
Entity
Organization
Contact information
Practice address
1150 E MATTHEWS AVE, STE 102, JONESBORO, AR 72401-4346
(870) 931-5437
Mailing address
PO BOX 3450, LITTLE ROCK, AR 72203-3450
(501) 781-2777
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
AR
Other
Enumeration date
01/04/2017
Last updated
01/04/2017
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