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General NPI Number Information
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NPI Number | 1386133155
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Entity Type | Organization
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Legal Business Name | TOOTH BE TOLD PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 930 15TH ST
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City | BATESVILLE
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State | AR
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Zip | 72501-5827
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Country | US
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Telephone | 870-208-3009
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Fax |
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Provider Business Mailing Address
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Address Line | 930 15TH ST
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City | BATESVILLE
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State | AR
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Zip | 72501-5827
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Country | US
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Telephone | 870-262-8118
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LESLEY MILTON
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Credential | DDS
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Telephone | 870-262-8118
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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 | 4189
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License Number State | AR
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