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General NPI Number Information
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NPI Number | 1245048321
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Entity Type | Organization
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Legal Business Name | DOVER AND HART DENTAL PLLC
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 400 S COLLEGE ST STE 1
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3991
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Country | US
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Telephone | 870-425-4777
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Fax |
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Provider Business Mailing Address
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Address Line | 400 S COLLEGE ST STE 1
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3991
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Country | US
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Telephone | 870-425-4777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN MICHAEL HART
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Credential | DDS MDS
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Telephone | 870-425-4777
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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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