MEDICARE: DR. RONALD ARTHUR ABBOTT DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1285628230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD ARTHUR ABBOTT DMD

Provider Business Mailing Address
First Line	:	154 HIGHLAND DR
Second Line	:
City	:	CABOT
State	:	AR
Zip	:	72023-7575
Country	:	US
Telephone Number	:	501-843-0956
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 FORT ROOTS DR
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-1709
Country	:	US
Telephone Number	:	501-257-2200
Fax Number	:	501-257-2207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	07/11/2007

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