| Arkansas Orthodontic Center | |
|
3409 Gateway Cove Jonesboro AR 72404 | |
| (870) 972-0460 | |
| Not Available |
| Full Name | Arkansas Orthodontic Center |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3409 Gateway Cove, Jonesboro, Arkansas |
| Authorized Official Name and Position | Benjamin Gray Burris (ORTHODONTIST) |
| Authorized Official Contact | 8709728249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arkansas Orthodontic Center 3409 Gateway Cove Jonesboro AR 72404 Ph: (870) 972-0460 | Arkansas Orthodontic Center 3409 Gateway Cove Jonesboro AR 72404 Ph: (870) 972-0460 |
| NPI Number | 1740449339 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740449339 | NPI | - | NPPES |
| 167957631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3465 (Arkansas) | Primary |
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