MEDICARE: DANIEL C HEARD DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3458	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376663872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL C HEARD DDS PA

Provider Business Mailing Address
First Line	:	2400 CRESTWOOD RD
Second Line	:	SUITE 205
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-6861
Country	:	US
Telephone Number	:	501-753-2244
Fax Number	:	501-753-9244

Provider Business Practice Location Address
First Line	:	2400 CRESTWOOD RD
Second Line	:	SUITE 205
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-6861
Country	:	US
Telephone Number	:	501-753-2244
Fax Number	:	501-753-9244

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL CARY HEARD
Credential	:	DDS
Telephone Number	:	501-753-2244

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	06/12/2008

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