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General NPI Number Information
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NPI Number | 1588473334
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Entity Type | Organization
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Legal Business Name | DALLAS COUNTY HEALTH SYSTEM INC
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 110 N CLIFTON ST
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City | FORDYCE
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State | AR
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Zip | 71742-3065
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Country | US
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Telephone | 870-352-3525
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Fax | 870-352-3533
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Provider Business Mailing Address
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Address Line | 110 N CLIFTON ST
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City | FORDYCE
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State | AR
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Zip | 71742-3065
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Country | US
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Telephone | 870-352-3525
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Fax | 870-352-3533
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Authorized Official
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Title or Position | CEO
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Name | DAN MANTZ
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Credential |
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Telephone | 870-352-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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