Provider Demographics
NPI:1134134703
Name:LEMONS-PRINCE, MARNY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARNY
Middle Name:L
Last Name:LEMONS-PRINCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 BRECKENRIDGE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-1558
Mailing Address - Country:US
Mailing Address - Phone:501-225-4644
Mailing Address - Fax:
Practice Address - Street 1:1225 BRECKENRIDGE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1558
Practice Address - Country:US
Practice Address - Phone:501-225-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR33231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR3323OtherDENTAL LICENSE