Healthcare Provider Details

I. General information

NPI: 1427237866
Provider Name (Legal Business Name): SAOMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 THOMPSON AVE
EL DORADO AR
71730-4569
US

IV. Provider business mailing address

318 THOMPSON AVE
EL DORADO AR
71730-4569
US

V. Phone/Fax

Practice location:
  • Phone: 870-863-0088
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2321
License Number StateAR

VIII. Authorized Official

Name: SARA CROSSLAND
Title or Position: FINANCIAL COORDINATOR
Credential:
Phone: 870-863-0088