| Dequeen Division | |
|
110 West Dequeen Avenue Suite B Dequeen AR 71832 | |
| (870) 642-7645 | |
| Not Available |
| Full Name | Dequeen Division |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 West Dequeen Avenue, Dequeen, Arkansas |
| Authorized Official Name and Position | Garland Reese Shuffield (BUSINESS MANAGER) |
| Authorized Official Contact | 8707779083 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dequeen Division 110 West Dequeen Avenue Suite B Dequeen AR 71832 Ph: (870) 642-7645 | Dequeen Division 110 West Dequeen Avenue Suite B Dequeen AR 71832 Ph: (870) 642-7645 |
| NPI Number | 1043445455 |
|---|---|
| Provider Enumeration Date | 05/29/2009 |
| Last Update Date | 05/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043445455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |