Organization
MIRANDA M CHILDS DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRANDA MICHELLE CHILDS DDS (OWNER/DENTIST)
(870) 245-2323
Entity
Organization
Contact information
Practice address
312 PROFESSIONAL PARK DR, SUITE D, ARKADELPHIA, AR 71923-5315
(870) 245-2323
(870) 245-2368
Mailing address
312 PROFESSIONAL PARK DR, SUITE D, ARKADELPHIA, AR 71923-5315
(870) 245-2323
(870) 245-2368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3103
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U242
BLUE CROSS
AR
01
—
766360
UNITED CONCORDIA
AR
Enumeration date
08/13/2007
Last updated
08/13/2007
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