Provider Demographics
NPI:1104020569
Name:JOHN L GARLINGHOUSE D.M.D.
Entity Type:Organization
Organization Name:JOHN L GARLINGHOUSE D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARLINGHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:479-521-0004
Mailing Address - Street 1:2680 E JOYCE BLVD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4554
Mailing Address - Country:US
Mailing Address - Phone:479-521-0004
Mailing Address - Fax:479-443-6542
Practice Address - Street 1:2680 E JOYCE BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4554
Practice Address - Country:US
Practice Address - Phone:479-521-0004
Practice Address - Fax:479-443-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR879294OtherUNITED CONCORDIA