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General NPI Number Information
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NPI Number | 1659712214
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Entity Type | Organization
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Legal Business Name | CHAD MATONE DENTAL SERVICES,P.L.L.C.
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 7400 N HILLS BLVD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72116-4539
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Country | US
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Telephone | 501-835-4567
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Fax | 501-834-9178
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Provider Business Mailing Address
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Address Line | PO BOX 241785
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0014
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Country | US
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Telephone | 501-205-1084
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD D. MATONE
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Credential | D.D.S.
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Telephone | 501-205-1084
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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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