Organization Name: | NORTHWEST ARKANSAS PEDIATRIC DENTAL CENTER |
NPI Number: | 1033155411 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY D RHODES (PRESIDENT) |
Mailing Address: | 5518 Walsh Ln Rogers |
State: | AR US |
Postal Code: | 727588947 |
Phone Number: | 4796316377 |
Fax Number: | 4792735967 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 01/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 2924 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |