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General NPI Number Information
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NPI Number | 1831089200
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Entity Type | Organization
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Legal Business Name | WALDRON FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 2114 RICE STREET
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City | WALDRON
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State | AR
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Zip | 72958-0907
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Country | US
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Telephone | 479-637-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 2114 RICE STREET
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City | WALDRON
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State | AR
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Zip | 72958-0907
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Country | US
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Telephone | 479-637-2725
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ISAAC LE
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Credential | DDS
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Telephone | 479-782-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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