Individual
DR. JONATHAN P DACUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7522 HIGHWAY 107, SHERWOOD, AR 72120-4645
(501) 834-4800
(501) 833-1414
Mailing address
7522 HIGHWAY 107, SHERWOOD, AR 72120-4645
(501) 834-4800
(501) 833-1414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2350
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58911
BLUE CROSS OF ARKANSAS
AR
01
—
807159
UNITED CONCORDIA
AR
Enumeration date
07/19/2006
Last updated
07/08/2007
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