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General NPI Number Information
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NPI Number | 1316932353
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Entity Type | Individual
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Provider Name | JEFFERY ALLEN CASEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 3905 N. MAIN ST
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City | HINDSVILLE
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State | AR
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Zip | 72738
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Country | US
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Telephone | 479-750-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 1498 EDWARDS PL SW APT A
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City | BOLLING AFB
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State | DC
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Zip | 20032-7353
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Country | US
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Telephone | 202-767-4150
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Fax | 202-404-7366
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3184
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License Number State | AR
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