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General NPI Number Information
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NPI Number | 1235538778
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Entity Type | Organization
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Legal Business Name | KARLA K. GAINES, D.D.S., P.A.
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 802 N DIXIELAND RD
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City | ROGERS
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State | AR
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Zip | 72756-3205
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Country | US
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Telephone | 479-936-8800
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Fax | 479-936-8808
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Provider Business Mailing Address
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Address Line | 802 N DIXIELAND RD
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City | ROGERS
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State | AR
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Zip | 72756-3205
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Country | US
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Telephone | 479-936-8800
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Fax | 479-936-8808
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KARLA KAY GAINES
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Credential | DDS
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Telephone | 479-936-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3098
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License Number State | AR
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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 | 3098
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License Number State | AR
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