Healthcare Provider Details

I. General information

NPI: 1417989112
Provider Name (Legal Business Name): SCOTT ALAN SCHOEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 HIGHLAND DR
LITTLE ROCK AR
72223-2002
US

IV. Provider business mailing address

5400 HIGHLAND DR
LITTLE ROCK AR
72223-2002
US

V. Phone/Fax

Practice location:
  • Phone: 501-225-8929
  • Fax: 501-225-0334
Mailing address:
  • Phone: 501-225-8929
  • Fax: 501-225-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberAR2999
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: