Provider Demographics
NPI:1174817100
Name:INMAN FAMILY DENTAL CLINIC, INC.-NLR
Entity Type:Organization
Organization Name:INMAN FAMILY DENTAL CLINIC, INC.-NLR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-945-2500
Mailing Address - Street 1:1802 HWY 161
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-3702
Mailing Address - Country:US
Mailing Address - Phone:501-945-2500
Mailing Address - Fax:501-945-4842
Practice Address - Street 1:1802 HWY 161
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-3702
Practice Address - Country:US
Practice Address - Phone:501-945-2500
Practice Address - Fax:501-945-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty