Organization
ARKANSAS FAMILY DENTAL, PA
Active
Other names
Tina H. Nichols, DDS, PA
Organization subpart
No
Provider details
NPI number
Authorized official
TINA NICHOLS DDS (OWNER/DENTIST)
(501) 312-7576
Entity
Organization
Contact information
Practice address
13600 DAVID O. DODD, LITTLE ROCK, AR 72210
(501) 312-7576
(501) 687-0669
Mailing address
13600 DAVID O. DODD, LITTLE ROCK, AR 72210
(501) 312-7576
(501) 687-0669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3311
AR
1223G0001X
General Practice Dentistry
3435
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181913631
—
AR
Enumeration date
03/07/2007
Last updated
04/25/2013
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