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General NPI Number Information
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NPI Number | 1518517838
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Entity Type | Organization
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Legal Business Name | PARIS DENTAL CLINIC PLLC
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 15 W MAIN ST
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City | PARIS
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State | AR
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Zip | 72855-3205
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Country | US
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Telephone | 479-963-3086
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Fax |
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Provider Business Mailing Address
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Address Line | 100 E HUNTINGTON AVE STE E
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City | JONESBORO
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State | AR
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Zip | 72401-2900
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Country | US
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Telephone | 870-974-1577
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/MEMBER
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Name | DR. WILLIAM R LITTLE
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Credential | DDS
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Telephone | 870-243-4406
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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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