| Clint Fulks, Inc. | |
|
1200 Ferguson Dr Suite 4 Benton AR 72015-3503 | |
| (501) 778-9222 | |
| (501) 778-9223 |
| Full Name | Clint Fulks, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1200 Ferguson Dr, Benton, Arkansas |
| Authorized Official Name and Position | Clint Allen Fulks (OWNER) |
| Authorized Official Contact | 5013504564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clint Fulks, Inc. 3316 Highway 5 N Suite 1 Bryant AR 72019-9031 Ph: (501) 847-6453 | Clint Fulks, Inc. 1200 Ferguson Dr Suite 4 Benton AR 72015-3503 Ph: (501) 778-9222 |
| NPI Number | 1467697003 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 06/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467697003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3521 (Arkansas) | Primary |
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