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General NPI Number Information
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NPI Number | 1134502628
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Entity Type | Individual
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Provider Name | ROSEMARY PELPHREY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 400 SW RAMSEY LN
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City | BENTONVILLE
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State | AR
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Zip | 72712-4859
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Country | US
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Telephone | 806-778-6869
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Fax |
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Provider Business Mailing Address
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Address Line | 400 SW RAMSEY LN
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City | BENTONVILLE
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State | AR
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Zip | 72712-4859
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Country | US
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Telephone | 806-252-2481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31132
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4287
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License Number State | AR
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