Healthcare Provider Details

I. General information

NPI: 1821010018
Provider Name (Legal Business Name): LEONA C. KEMPER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6189 HEBER SPRINGS RD. W.
QUITMAN AR
72131-0217
US

IV. Provider business mailing address

PO BOX 217
QUITMAN AR
72131-0217
US

V. Phone/Fax

Practice location:
  • Phone: 501-589-3323
  • Fax:
Mailing address:
  • Phone: 501-589-3323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2892
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: