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General NPI Number Information
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NPI Number | 1609158153
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Entity Type | Organization
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Legal Business Name | DRS. NATHANIEL AND KATHERINE BEHRENTS DDS, PC
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Dates
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Enumeration Date | 09/11/2011
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Last Update Date | 09/11/2011
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Provider Practice Location Address
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Address Line | 152 E APPLEBY RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3903
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Country | US
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Telephone | 901-277-5099
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Fax | 479-445-6942
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Provider Business Mailing Address
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Address Line | 152 E APPLEBY RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-3903
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Country | US
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Telephone | 901-277-5099
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Fax | 479-445-6942
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NATHANIEL BEHRENTS
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Credential | DDS, MS
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Telephone | 901-277-5099
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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 | 3819
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License Number State | AR
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