Healthcare Provider Details

I. General information

NPI: 1659712214
Provider Name (Legal Business Name): CHAD MATONE DENTAL SERVICES,P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N HILLS BLVD
NORTH LITTLE ROCK AR
72116-4539
US

IV. Provider business mailing address

PO BOX 241785
LITTLE ROCK AR
72223-0014
US

V. Phone/Fax

Practice location:
  • Phone: 501-835-4567
  • Fax: 501-834-9178
Mailing address:
  • Phone: 501-205-1084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CHAD D. MATONE
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 501-205-1084