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General NPI Number Information
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NPI Number | 1215055967
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Entity Type | Organization
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Legal Business Name | DR. KARLA BALTZ, DDS, PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 151 COUNTRY CLUB ROAD
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City | POCAHONTAS
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State | AR
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Zip | 72455-1364
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Country | US
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Telephone | 870-892-1211
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Fax | 870-892-4804
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Provider Business Mailing Address
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Address Line | 151 COUNTRY CLUB ROAD
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City | POCAHONTAS
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State | AR
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Zip | 72455-1364
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Country | US
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Telephone | 870-892-1211
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Fax | 870-892-4804
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGIE DECLERK
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Credential |
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Telephone | 870-892-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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