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General NPI Number Information
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NPI Number | 1790155992
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Entity Type | Organization
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Legal Business Name | TED M. PINNEY, DDS, PA
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 815 MARSHALL RD
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3744
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Country | US
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Telephone | 501-982-4447
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Fax |
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Provider Business Mailing Address
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Address Line | 815 MARSHALL RD
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3744
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Country | US
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Telephone | 501-982-4447
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. TED PINNEY
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Credential | DDS
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Telephone | 501-982-4447
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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 | 3474
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License Number State | AR
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