Healthcare Provider Details
I. General information
NPI: 1164369443
Provider Name (Legal Business Name): SOUTH ARKANSAS ORAL SURGERY AND IMPLANT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
106 W MAIN ST STE 310
EL DORADO AR
71730-5636
US
IV. Provider business mailing address
4715 BAY HILL DR
CONWAY AR
72034-8292
US
V. Phone/Fax
- Phone: 910-992-1251
- Fax:
- Phone: 910-992-1251
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204E00000X |
| Taxonomy | Oral & Maxillofacial Surgery (D.M.D.) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
PATTON
BATSON
Title or Position: OWNER/OPERATOR
Credential: DDS/OMFS
Phone: 910-992-1251