Healthcare Provider Details

I. General information

NPI: 1750390118
Provider Name (Legal Business Name): FORT SMITH ORAL & MAXILLOFACIAL SURGERY GROUP PA-CURRY AND BUTLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2713 S 74TH ST SUITE 201
FORT SMITH AR
72903-5170
US

IV. Provider business mailing address

2713 S 74TH ST SUITE 201
FORT SMITH AR
72903-5170
US

V. Phone/Fax

Practice location:
  • Phone: 479-484-0200
  • Fax: 479-484-9346
Mailing address:
  • Phone: 479-484-0200
  • Fax: 479-484-9346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number353
License Number StateAR

VIII. Authorized Official

Name: DR. WILLIAM E CURRY
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 479-484-0200