| Amity Gentle Dental | |
|
439 E Thompson St Amity AR 71921-8602 | |
| (870) 342-5265 | |
| (870) 342-6292 |
| Full Name | Amity Gentle Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 439 E Thompson St, Amity, Arkansas |
| Authorized Official Name and Position | Chester V Clark (PRESIDENT) |
| Authorized Official Contact | 8703425265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amity Gentle Dental Po Box 154 Amity AR 71921-0154 Ph: (870) 342-5265 | Amity Gentle Dental 439 E Thompson St Amity AR 71921-8602 Ph: (870) 342-5265 |
| NPI Number | 1962574327 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 01/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962574327 | NPI | - | NPPES |
| 58932 | Other | AR | ARKANSAS BCBS PROVIDER ID |
| 101460608 | Medicaid | AR | |
| 809875 | Other | AR | UNITED CONCORDIA PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2228 (Arkansas) | Primary |