| Kevin R. Mann Dds, Pa | |
|
1224 W Court St Paragould AR 72450-4132 | |
| (870) 239-5518 | |
| Not Available |
| Full Name | Kevin R. Mann Dds, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1224 W Court St, Paragould, Arkansas |
| Authorized Official Name and Position | Kevin Ryan Mann (PRESIDENT) |
| Authorized Official Contact | 8702395518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin R. Mann Dds, Pa 1224 W Court St Paragould AR 72450-4132 Ph: (870) 239-5518 | Kevin R. Mann Dds, Pa 1224 W Court St Paragould AR 72450-4132 Ph: (870) 239-5518 |
| NPI Number | 1275779258 |
|---|---|
| Provider Enumeration Date | 12/23/2008 |
| Last Update Date | 12/23/2008 |
| Medicare PECOS PAC ID | 7315345873 |
|---|---|
| Medicare Enrollment ID | O20211013003029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275779258 | NPI | - | NPPES |
| 168213608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3666 (Arkansas) | Primary |
| Provider Name | Kevin R Mann |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1528229960 PECOS PAC ID: 2769788579 Enrollment ID: I20211013003099 |
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