Organization
LE WESTERN DENTISTRY, PLLC
Active
Parent organization
LE WESTERN DENTISTRY, PLLC
Other names
Charleston Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
LE WESTERN DENTISTRY, PLLC
Authorized official
CASSI LYNN WORK (CLINIC COORDINATOR)
(479) 782-3005
Entity
Organization
Contact information
Practice address
16 CHURCH ST, CHARLESTON, AR 72933-9190
(479) 965-2291
(479) 965-2292
Mailing address
PO BOX 308, CHARLESTON, AR 72933-0308
(479) 965-2291
(479) 965-2292
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154867893
GROUP NPI
AR
Enumeration date
03/27/2019
Last updated
03/27/2019
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