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General NPI Number Information
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NPI Number | 1598812224
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Entity Type | Organization
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Legal Business Name | CALVIN B. SUFFRIDGE, DDS, PA
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 8 PARKSTONE CIR SUITE B
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7086
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Country | US
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Telephone | 501-907-6000
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Fax | 501-907-5664
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Provider Business Mailing Address
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Address Line | 8 PARKSTONE CIR SUITE B
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-7086
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Country | US
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Telephone | 501-907-6000
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Fax | 501-907-5664
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Authorized Official
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Title or Position | ENDODONTIST
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Name | DR. CALVIN BUFORD SUFFRIDGE
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Credential | DDS
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Telephone | 501-907-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 3182
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License Number State | AR
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