Provider Demographics
NPI:1093892838
Name:WILLIAM R VOSS DDS PA
Entity Type:Organization
Organization Name:WILLIAM R VOSS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-337-7422
Mailing Address - Street 1:206 E HIGHLAND
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104
Mailing Address - Country:US
Mailing Address - Phone:501-337-7422
Mailing Address - Fax:501-337-9044
Practice Address - Street 1:206 E HIGHLAND
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104
Practice Address - Country:US
Practice Address - Phone:501-337-7422
Practice Address - Fax:501-337-9044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR114980608Medicaid