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General NPI Number Information
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NPI Number | 1508727504
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Entity Type | Organization
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Legal Business Name | CAPITOL ORAL SURGERY & IMPLANT CENTER LLC
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 5 SAINT VINCENT CIR STE 100
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5415
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Country | US
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Telephone | 501-672-9911
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Fax | 866-578-8191
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Provider Business Mailing Address
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Address Line | 2307 W BEEBE CAPPS EXPY # 166
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City | SEARCY
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State | AR
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Zip | 72143-4905
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Country | US
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Telephone |
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Fax | 866-578-8191
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Authorized Official
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Title or Position | MANAGER
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Name | BETHANY ABBOTT
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Credential |
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Telephone | 501-672-9911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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