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General NPI Number Information
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NPI Number | 1982712139
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Entity Type | Organization
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Legal Business Name | ROBERT E. NOSARI, D.D.S., P.A.
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Dates
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Enumeration Date | 08/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 26 GREEN VALLEY DR
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-8102
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Country | US
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Telephone | 870-425-6911
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Fax | 870-424-4891
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Provider Business Mailing Address
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Address Line | 26 GREEN VALLEY DR
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-8102
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Country | US
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Telephone | 870-425-6911
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Fax | 870-424-4891
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Authorized Official
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Title or Position | DENTIST
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Name | ROBERT ELMO NOSARI
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Credential | D.D.S.
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Telephone | 870-425-6911
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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 | 1789
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License Number State | AR
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