Provider Demographics
NPI:1154481315
Name:SEARCY DENTAL ASSOCIATES, P.A. TODD BRYAN WYATT, D.M.D.
Entity Type:Organization
Organization Name:SEARCY DENTAL ASSOCIATES, P.A. TODD BRYAN WYATT, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:501-268-3666
Mailing Address - Street 1:710 MARION ST STE 302
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4880
Mailing Address - Country:US
Mailing Address - Phone:501-268-3666
Mailing Address - Fax:501-268-0220
Practice Address - Street 1:710 MARION ST STE 302
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4880
Practice Address - Country:US
Practice Address - Phone:501-268-3666
Practice Address - Fax:501-268-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty