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General NPI Number Information
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NPI Number | 1487855417
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Entity Type | Organization
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Legal Business Name | DR HEATHER BOND SOUTHARD, DDS PA
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 04/17/2014
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Provider Practice Location Address
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Address Line | 2600 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7226
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Country | US
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Telephone | 870-932-7000
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Fax | 870-932-1650
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Provider Business Mailing Address
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Address Line | 2600 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7226
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Country | US
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Telephone | 870-932-7000
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Fax | 870-932-1650
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HEATHER BOND SOUTHARD
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Credential | DDS
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Telephone | 870-932-7000
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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 | 3469
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License Number State | AR
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