MEDICARE: DR. DANIEL CARY 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	1729401	OTHER	AR	UNITED CONCORDIAN PROV ID
2	5Y366	OTHER	AR	AR BCBS PROV ID

General Provider Information

NPI Number	:	1942372065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL CARY 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	:

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/09/2007

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