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General NPI Number Information
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NPI Number | 1518475508
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Entity Type | Organization
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Legal Business Name | SHARP FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 3284 HIGHWAY 367 S
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City | CABOT
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State | AR
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Zip | 72023
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Country | US
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Telephone | 501-843-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 3284 HIGHWAY 367 S
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City | CABOT
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State | AR
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Zip | 72023-7444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. ALEX SHARP
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Credential | DDS
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Telephone | 501-843-5808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 4047
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License Number State | AR
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