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General NPI Number Information
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NPI Number | 1013043322
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Entity Type | Organization
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Legal Business Name | RICHARD L. GORE D.D.S.,P.A.
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11 OFFICE PARK DR
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3843
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Country | US
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Telephone | 501-225-2929
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Fax | 501-228-6646
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Provider Business Mailing Address
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Address Line | 11 OFFICE PARK DR
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3843
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Country | US
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Telephone | 501-225-2929
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Fax | 501-228-6646
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD LLOYD GORE
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Credential | D.D.S.
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Telephone | 501-225-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 284
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License Number State | AR
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