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General NPI Number Information
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NPI Number | 1780153247
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Entity Type | Organization
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Legal Business Name | D&M DENTISTRY, LLC
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 11/14/2018
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Provider Practice Location Address
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Address Line | 810 N FOURCHE AVE
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City | PERRYVILLE
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State | AR
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Zip | 72126-8546
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Country | US
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Telephone | 501-977-3393
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Fax |
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Provider Business Mailing Address
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Address Line | 810 N FOURCHE AVE
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City | PERRYVILLE
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State | AR
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Zip | 72126-8546
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Country | US
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Telephone | 501-977-3393
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Fax |
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Authorized Official
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Title or Position | OWNER/DDS
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Name | DR. ZACHARY RANDALL DIXON
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Credential | DDS
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Telephone | 501-977-3393
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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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