Healthcare Provider Details

I. General information

NPI: 1366552788
Provider Name (Legal Business Name): HOT SPRINGS NATIONAL PARK DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 CARPENTER DAM RD STE M
HOT SPRINGS AR
71901-8282
US

IV. Provider business mailing address

307 CARPENTER DAM RD STE M
HOT SPRINGS AR
71901-8282
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-3323
  • Fax: 501-262-9790
Mailing address:
  • Phone: 501-624-3323
  • Fax: 501-262-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateAR

VIII. Authorized Official

Name: DR. STUART A. FLEISCHNER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 501-624-3323