| Forrest L Moudy Dds Pa Inc | |
|
105 E 10th St Danville AR 72833-0878 | |
| (479) 495-2115 | |
| (479) 495-2267 |
| Full Name | Forrest L Moudy Dds Pa Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 105 E 10th St, Danville, Arkansas |
| Authorized Official Name and Position | Forrest L Moudy (PRESIDENT) |
| Authorized Official Contact | 4794952115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forrest L Moudy Dds Pa Inc Po Box 878 Danville AR 72833-0878 Ph: (479) 495-2115 | Forrest L Moudy Dds Pa Inc 105 E 10th St Danville AR 72833-0878 Ph: (479) 495-2115 |
| NPI Number | 1437256948 |
|---|---|
| Provider Enumeration Date | 09/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437256948 | NPI | - | NPPES |
| 58359 | Other | AR | BLUE CROSS BLUE SHIELD |
| 846563 | Other | AR | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2030 (Arkansas) | Primary |