MEDICARE: TWO THIRTY DENTAL LLC

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

General Provider Information

NPI Number	:	1598611469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWO THIRTY DENTAL LLC

Provider Business Mailing Address
First Line	:	103 PLAZA CARMONA PL
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 PLAZA CARMONA PL
Second Line	:
City	:	HOT SPRINGS VILLAGE
State	:	AR
Zip	:	71909-3000
Country	:	US
Telephone Number	:	501-922-2600
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	CAMRYN BRYANT
Credential	:
Telephone Number	:	501-538-9708

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “TWO THIRTY DENTAL LLC ” Practice Location

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