Healthcare Provider Details

I. General information

NPI: 1336351774
Provider Name (Legal Business Name): CORNERSTONE MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 OAKLAND AVE STE A
HELENA AR
72342-1518
US

IV. Provider business mailing address

663 OAKLAND AVE STE A
HELENA AR
72342-1518
US

V. Phone/Fax

Practice location:
  • Phone: 870-572-6575
  • Fax: 870-572-6265
Mailing address:
  • Phone: 870-572-6575
  • Fax: 870-572-6265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number3017
License Number StateAR

VIII. Authorized Official

Name: DR. LARRY REXEL BROWNING JR.
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 870-572-6575