Organization
RONNIE L FAULKNER, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE LEE FAULKNER DDS (PRESIDE)
(501) 276-3432
Entity
Organization
Contact information
Practice address
138 HIGHWAY 270 E, MOUNT IDA, AR 71957-9409
(870) 867-3432
(870) 867-3783
Mailing address
PO BOX 901, MOUNT IDA, AR 71957-0901
(870) 867-3432
(870) 867-3783
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111161608
—
AR
Enumeration date
11/18/2020
Last updated
11/18/2020
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