| Blayne Tipton Dds Pa | |
|
307 G Carpenter Dam Road Hot Springs AR 71901 | |
| (501) 520-5437 | |
| (501) 520-5433 |
| Full Name | Blayne Tipton Dds Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 307 G Carpenter Dam Road, Hot Springs, Arkansas |
| Authorized Official Name and Position | Blayne H Tipton (PRESIDENT) |
| Authorized Official Contact | 5015205437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blayne Tipton Dds Pa 307 G Carpenter Dam Road Hot Springs AR 71901 Ph: (501) 520-5437 | Blayne Tipton Dds Pa 307 G Carpenter Dam Road Hot Springs AR 71901 Ph: (501) 520-5437 |
| NPI Number | 1508016163 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 11/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508016163 | NPI | - | NPPES |
| 171064631 | Medicaid | AR | |
| 154429608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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