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General NPI Number Information
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NPI Number | 1750973046
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Entity Type | Organization
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Legal Business Name | LARRY E SIPES DDS PA
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 607 N COLLEGE AVE
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City | EL DORADO
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State | AR
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Zip | 71730-4504
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Country | US
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Telephone | 870-864-9788
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Fax |
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Provider Business Mailing Address
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Address Line | 607 N COLLEGE AVE
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City | EL DORADO
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State | AR
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Zip | 71730-4504
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Country | US
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Telephone | 870-864-9788
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KAREN D LINDSEY
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Credential |
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Telephone | 870-866-9321
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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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