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General NPI Number Information
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NPI Number | 1275092710
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Entity Type | Organization
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Legal Business Name | SANDLIN DENTISTRY PLLC
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 1699 RED WOLF BLVD STE 1
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City | JONEBORO
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State | AR
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Zip | 72401-5453
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Country | US
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Telephone | 870-336-0543
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Fax |
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Provider Business Mailing Address
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Address Line | 1699 RED WOLF BLVD STE 1
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City | JONEBORO
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State | AR
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Zip | 72401-5453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | JACOB SANDLIN
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Credential | D.D.S.
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Telephone | 870-336-0543
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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 |
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License Number State |
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