MEDICARE: JOHN DEAN, D.D.S., P.A.

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	3118	AR

General Provider Information

NPI Number	:	1588780688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN DEAN, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	2524 CRESTWOOD RD STE 2
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7648
Country	:	US
Telephone Number	:	501-771-2911
Fax Number	:	501-758-2078

Provider Business Practice Location Address
First Line	:	2524 CRESTWOOD RD STE 2
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-7648
Country	:	US
Telephone Number	:	501-771-2911
Fax Number	:	501-758-2078

Authorized Official
Title or Position	:	RDH
Name	:	DAWN FINNEGAN
Credential	:	DO
Telephone Number	:	501-837-4189

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/01/2019

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