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General NPI Number Information
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NPI Number | 1477780302
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Entity Type | Organization
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Legal Business Name | DR. JOHN T. AHRENS D.M.D. PA
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 403 E 7TH ST
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3948
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Country | US
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Telephone | 870-425-3730
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Fax | 870-425-1504
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Provider Business Mailing Address
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Address Line | 403 E 7TH ST
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-3948
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Country | US
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Telephone |
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Fax | 870-425-1504
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN T AHRENS
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Credential | MDM
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Telephone | 870-425-3730
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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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