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General NPI Number Information
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NPI Number | 1780834929
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Entity Type | Organization
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Legal Business Name | ERIC SHARKS, DDS, P.C.
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 1350 S GUTENSOHN RD SUITE 1
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City | SPRINGDALE
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State | AR
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Zip | 72762-5117
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Country | US
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Telephone | 479-872-2700
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Fax | 479-872-2722
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Provider Business Mailing Address
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Address Line | 1350 S GUTENSOHN RD SUITE 1
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City | SPRINGDALE
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State | AR
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Zip | 72762-5117
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Country | US
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Telephone | 479-872-2700
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Fax | 479-872-2722
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. ERIC SHARKS
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Credential | DDS
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Telephone | 479-872-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3252
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License Number State | AR
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