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General NPI Number Information
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NPI Number | 1225395437
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Entity Type | Organization
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Legal Business Name | SCARBROUGH DENTISTRY INC.
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 2009 W BEEBE CAPPS EXPY
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City | SEARCY
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State | AR
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Zip | 72143-5014
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Country | US
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Telephone | 501-279-9599
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Fax | 501-279-3679
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Provider Business Mailing Address
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Address Line | 101 SHAWN TER
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City | SEARCY
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State | AR
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Zip | 72143-8659
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Country | US
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Telephone | 501-279-9599
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Fax | 501-279-3679
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH R. SCARBROUGH
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Credential | DDS
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Telephone | 501-279-9599
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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 | AR3016
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License Number State | AR
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