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General NPI Number Information
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NPI Number | 1346461225
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Entity Type | Organization
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Legal Business Name | PATRICK AND ASHLEY FIELDS FAMILY DENTISTRY, P.A.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 183 ARENA RD SUITE C
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City | CABOT
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State | AR
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Zip | 72023-7961
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Country | US
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Telephone | 501-941-2482
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Fax | 501-941-2483
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Provider Business Mailing Address
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Address Line | 183 ARENA RD SUITE C
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City | CABOT
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State | AR
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Zip | 72023-7961
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Country | US
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Telephone | 501-941-2482
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Fax | 501-941-2483
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | SANDY HUNTER
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Credential |
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Telephone | 501-941-2482
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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 | 3417
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3433
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License Number State | AR
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