Healthcare Provider Details
I. General information
NPI: 1386022283
Provider Name (Legal Business Name): TRUE DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2015
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 SE PLAZA AVE STE 5
BENTONVILLE AR
72712-5473
US
IV. Provider business mailing address
901 SE PLAZA AVE STE 5
BENTONVILLE AR
72712-5473
US
V. Phone/Fax
- Phone: 479-273-3376
- Fax: 479-273-3468
- Phone: 479-876-8550
- Fax: 479-208-4266
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CARLA
MILLS
Title or Position: BILLING MANAGER
Credential:
Phone: 479-876-8520