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General NPI Number Information
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NPI Number | 1336620020
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Entity Type | Organization
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Legal Business Name | SMALL BITES
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 1001 S BOWMAN RD STE 1
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3710
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Country | US
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Telephone | 501-222-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S BOWMAN RD STE 1
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3710
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Country | US
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Telephone | 501-222-9101
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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. DAVID KEITH JONES
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Credential | DDS
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Telephone | 901-359-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 3877
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License Number State | AR
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