Individual
DR. MICHAEL ANTHONY KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
14114 TAYLOR LOOP RD, LITTLE ROCK, AR 72223
(501) 868-3331
(501) 868-5323
Mailing address
14114 TAYLOR LOOP RD., LITTLE ROCK, AR 72223
(501) 868-3331
(501) 868-5323
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3512
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155664608
—
AR
01
—
5C240
BCBS GROUP ID NUMBER
AR
Enumeration date
01/10/2007
Last updated
11/21/2011
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