MEDICARE: ROCK DENTAL ARKANSAS PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
2	1223P0300X	Periodontics
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
4	1223G0001X	General Practice Dentistry
5	1223P0221X	Pediatric Dentistry
6	122300000X	Dentist

General Provider Information

NPI Number	:	1336659085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK DENTAL ARKANSAS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 3450
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72203-3450
Country	:	US
Telephone Number	:	501-781-2777
Fax Number	:	501-781-2778

Provider Business Practice Location Address
First Line	:	3320 CENTRAL AVE
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6139
Country	:	US
Telephone Number	:	501-321-0560
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARK L. DAKE
Credential	:	DDS, MBR
Telephone Number	:	501-462-2062

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	01/20/2026

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