| Dequeen Dental | |
|
1347 W Collin Raye Dr De Queen AR 71832-2946 | |
| (870) 642-5034 | |
| (870) 642-2365 |
| Full Name | Dequeen Dental |
|---|---|
| Speciality | Dentist |
| Location | 1347 W Collin Raye Dr, De Queen, Arkansas |
| Authorized Official Name and Position | Christie Jaquess (PHYSICIAN) |
| Authorized Official Contact | 8706425034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dequeen Dental 1347 W Collin Raye Dr De Queen AR 71832-2946 Ph: (870) 642-5034 | Dequeen Dental 1347 W Collin Raye Dr De Queen AR 71832-2946 Ph: (870) 642-5034 |
| NPI Number | 1548681885 |
|---|---|
| Provider Enumeration Date | 01/03/2014 |
| Last Update Date | 01/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548681885 | NPI | - | NPPES |
| 199929631 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3669 (Arkansas) | Primary |
Mark R. Stewart, Dmd, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1316 W Collin Raye Dr, Suite A, De Queen, AR 71832 Phone: 870-584-3221 Fax: 870-642-6846 |