Healthcare Provider Details

I. General information

NPI: 1497310288
Provider Name (Legal Business Name): LUKE FRUCHEY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14810 CANTRELL RD STE 150
LITTLE ROCK AR
72223-4681
US

IV. Provider business mailing address

14810 CANTRELL RD STE 150
LITTLE ROCK AR
72223-4681
US

V. Phone/Fax

Practice location:
  • Phone: 501-673-3905
  • Fax:
Mailing address:
  • Phone: 501-673-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4364
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: