Healthcare Provider Details

I. General information

NPI: 1942065263
Provider Name (Legal Business Name): BRADLEY R CROSSFIELD DDS OF NORTHWEST ARKANSAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 E JOYCE BLVD STE 221
FAYETTEVILLE AR
72703-6392
US

IV. Provider business mailing address

PO BOX 677
CENTERTON AR
72719-0677
US

V. Phone/Fax

Practice location:
  • Phone: 501-951-0031
  • Fax:
Mailing address:
  • Phone: 479-326-7551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRADLEY CROSSFIELD
Title or Position: OWNER
Credential: DDS
Phone: 501-951-0031