Organization
BLYTHEVILLE PEDIATRIC DENTISTRY, PLLC
Active
Other names
Children's Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMMIE A BURROWS (OFFICE MANAGER)
(870) 739-2992
Entity
Organization
Contact information
Practice address
646 E MAIN ST STE B, BLYTHEVILLE, AR 72315-2125
(870) 824-6677
Mailing address
914 OLD HIGHWAY 64, CRAWFORDSVILLE, AR 72327-2311
(870) 739-2992
(870) 739-8597
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3647
AR
Other
Enumeration date
10/23/2013
Last updated
10/23/2013
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