Organization
AXPM SW LITTLE ROCK PEDO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN HILLER (OWNER)
(501) 781-2777
Entity
Organization
Contact information
Practice address
9100 GEYER SPRINGS RD, LITTLE ROCK, AR 72209-6425
(501) 565-0444
Mailing address
PO BOX 24470, LITTLE ROCK, AR 72221-4470
(501) 781-2777
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3321
AR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3763
AR
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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