Organization
MY VILLAGE SMILES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM T MAHON D.D.S., M.S., M.S (OWNER)
(479) 621-9500
Entity
Organization
Contact information
Practice address
1104 POPLAR PL, ROGERS, AR 72756-4249
(479) 621-9500
(479) 202-5361
Mailing address
1104 POPLAR PL, ROGERS, AR 72756-4249
(479) 621-9500
(479) 202-5361
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
2401
AR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2401
AR
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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