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General NPI Number Information
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NPI Number | 1104282797
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Entity Type | Organization
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Legal Business Name | HORIZON DENTAL GROUP LLC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 2900 HORIZON DR SUITE 13
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City | BRYANT
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State | AR
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Zip | 72022-9058
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Country | US
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Telephone | 501-847-5437
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Fax | 501-847-5439
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Provider Business Mailing Address
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Address Line | 2900 HORIZON DR SUITE 13
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City | BRYANT
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State | AR
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Zip | 72022-9058
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Country | US
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Telephone | 501-847-5437
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Fax | 501-847-5439
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. RICHARD A CAIN
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Credential | D.D.S.
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Telephone | 501-847-5437
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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 | 2385
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License Number State | AR
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