Organization
KENNETH E PEARSON DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY C HASTINGS (OFFICE MANAGER)
(501) 221-1200
Entity
Organization
Contact information
Practice address
12921 CANTRELL RD SUITE 200, LITTLE ROCK, AR 72223
(501) 221-1200
(501) 221-1326
Mailing address
12921 CANTRELL RD SUITE 200, LITTLE ROCK, AR 72223
(501) 221-1200
(501) 221-1326
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2694
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111380608
—
AR
01
—
56311
BCBS
—
01
—
696033
UNITED CONCORDIA
—
Enumeration date
03/23/2007
Last updated
07/11/2008
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