Organization
AR DENTAL & TMJ - JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ERIN CUPAN (PRACTICE ADMINISTRATOR)
(501) 225-1577
Entity
Organization
Contact information
Practice address
1426 BRADEN ST, JACKSONVILLE, AR 72076-3721
(501) 982-3777
(501) 982-3433
Mailing address
1426 BRADEN ST, JACKSONVILLE, AR 72076-3721
(501) 982-3777
(501) 982-3433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
AR
Other
Enumeration date
03/13/2012
Last updated
08/02/2012
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