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General NPI Number Information
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NPI Number | 1538308598
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Entity Type | Organization
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Legal Business Name | SHOWALTER FAMILY DENTISTRY
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 2616 W BEEBE CAPPS EXPY
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City | SEARCY
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State | AR
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Zip | 72143-4968
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Country | US
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Telephone | 500-126-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 2616 W BEEBE CAPPS EXPY
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City | SEARCY
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State | AR
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Zip | 72143-4968
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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 | D.D.S.
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Name | DR. KEN SHOWALTER
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Credential |
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Telephone | 501-268-8669
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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 | 2191
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License Number State | AR
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