MEDICARE: JOSH MANSFIELD DDS

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	122300000X	Dentist	3987	AR

General Provider Information

NPI Number	:	1962817304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSH MANSFIELD DDS

Provider Business Mailing Address
First Line	:	809 MARSHALL RD
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-3744
Country	:	US
Telephone Number	:	501-982-4444
Fax Number	:	501-982-6616

Provider Business Practice Location Address
First Line	:	809 MARSHALL RD
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-3744
Country	:	US
Telephone Number	:	501-982-4444
Fax Number	:	501-982-6616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	04/20/2023

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Directions to “ JOSH MANSFIELD DDS” Practice Location

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