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General NPI Number Information
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NPI Number | 1952502601
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Entity Type | Organization
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Legal Business Name | ANITA L. AEBERSOLD, DDS PA
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 820 N. UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-664-1733
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Fax | 501-664-1759
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Provider Business Mailing Address
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Address Line | 820 N. UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-664-1733
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Fax | 501-664-1759
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANITA L. AEBERSOLD
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Credential | DDS
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Telephone | 501-664-1733
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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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