Healthcare Provider Details

I. General information

NPI: 1891607875
Provider Name (Legal Business Name): HERMAN E. HURD, DDS, IX, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E NARROWAY STE 200
BENTON AR
72015-3441
US

IV. Provider business mailing address

1300 SLACK ST
PEA RIDGE AR
72751-3914
US

V. Phone/Fax

Practice location:
  • Phone: 479-488-6131
  • Fax:
Mailing address:
  • Phone: 479-488-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MADISON PORTER
Title or Position: CEO
Credential:
Phone: 501-683-9762