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General NPI Number Information
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NPI Number | 1265643720
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Entity Type | Individual
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Provider Name | CAROL R. DENNIS B. S., R. D. H.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3518 LACROSSE
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City | BRYANT
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State | AR
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Zip | 72022-9314
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Country | US
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Telephone | 501-658-3556
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Fax | 501-257-2206
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Provider Business Mailing Address
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Address Line | 3518 LACROSSE DR.
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City | BRYANT
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State | AR
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Zip | 72022
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Country | US
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Telephone | 501-658-3556
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Fax | 501-257-2206
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 561
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1679
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License Number State | AR
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