Organization
STEVE MANGAN, D.D.S., P.A.
Active
Other names
Steve Mangan, D.D.S., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES STEVEN MANGAN III D.D.S. (DENTIST)
(501) 666-1188
Entity
Organization
Contact information
Practice address
2011 N VAN BUREN ST, LITTLE ROCK, AR 72207-4739
(501) 666-1188
(501) 666-1189
Mailing address
2011 N VAN BUREN ST, LITTLE ROCK, AR 72207-4739
(501) 666-1188
(501) 666-1189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR2807
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58242
BLUE CROSS BLUE SHIELD
AR
01
—
662941
UNITED CONCORDIA
AR
Enumeration date
02/21/2007
Last updated
08/22/2020
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