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General NPI Number Information
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NPI Number | 1154481315
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Entity Type | Organization
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Legal Business Name | SEARCY DENTAL ASSOCIATES, P.A. TODD BRYAN WYATT, D.M.D.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 710 MARION ST STE 302
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City | SEARCY
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State | AR
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Zip | 72143-4880
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Country | US
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Telephone | 501-268-3666
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Fax | 501-268-0220
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Provider Business Mailing Address
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Address Line | 710 MARION ST STE 302
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City | SEARCY
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State | AR
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Zip | 72143-4880
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Country | US
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Telephone | 501-268-3666
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Fax | 501-268-0220
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD BRYAN WYATT
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Credential | D.M.D.
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Telephone | 501-268-3666
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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 |
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License Number State |
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