Healthcare Provider Details

I. General information

NPI: 1154401057
Provider Name (Legal Business Name): SANDERS, TOMPKINS, SCHIRO, LANDERS AND SANDERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 E RAINFOREST DR
FAYETTEVILLE AR
72703-5385
US

IV. Provider business mailing address

1607 E RAINFOREST DR
FAYETTEVILLE AR
72703-5385
US

V. Phone/Fax

Practice location:
  • Phone: 479-582-0600
  • Fax: 479-443-4630
Mailing address:
  • Phone: 479-582-0600
  • Fax: 479-443-4630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number StateAR

VIII. Authorized Official

Name: ROCIO RODRIGUEZ
Title or Position: HUMAN RESOURCES COORDINATOR
Credential:
Phone: 479-582-0600