Healthcare Provider Details

I. General information

NPI: 1023240595
Provider Name (Legal Business Name): CENTRAL ARKANSAS ORTHODONTIC ASSOCIATES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 CENTRAL AVENUE
HOT SPRINGS AR
71913
US

IV. Provider business mailing address

5100 TALLEY RD STE 100
LITTLE ROCK AR
72204-8032
US

V. Phone/Fax

Practice location:
  • Phone: 501-321-0560
  • Fax: 501-321-0551
Mailing address:
  • Phone: 501-321-0560
  • Fax: 501-321-0551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. BRYAN HILLER
Title or Position: ORTHODONTIST
Credential:
Phone: 501-321-0560