Provider Demographics
NPI:1043544307
Name:HART AND COCO PROSTHODONTICS
Entity Type:Organization
Organization Name:HART AND COCO PROSTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MDS
Authorized Official - Phone:501-319-7520
Mailing Address - Street 1:8028 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2419
Mailing Address - Country:US
Mailing Address - Phone:501-319-7520
Mailing Address - Fax:501-319-7521
Practice Address - Street 1:8028 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2419
Practice Address - Country:US
Practice Address - Phone:501-319-7520
Practice Address - Fax:501-319-7521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223P0700X
AR3543261QD0000X
AR3533261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty