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General NPI Number Information
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NPI Number | 1740480847
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Entity Type | Organization
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Legal Business Name | CLIFTON C. HIGGINS, D.D.S., P.A.
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 820 E MATTHEWS AVE SUITE B
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City | JONESBORO
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State | AR
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Zip | 72401-3048
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Country | US
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Telephone | 870-931-3377
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Fax | 870-931-3377
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Provider Business Mailing Address
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Address Line | 820 E MATTHEWS AVE SUITE B
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City | JONESBORO
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State | AR
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Zip | 72401-3048
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Country | US
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Telephone | 870-931-3377
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Fax | 870-931-3377
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Authorized Official
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Title or Position | BUSINESS ADMINISTRATOR
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Name | MRS. LEIANDREA LYNN HIGGINS
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Credential | BS, RDA
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Telephone | 870-935-7979
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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 | 3096
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License Number State | AR
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