Provider Demographics
NPI:1275735771
Name:JAY R OWENS JR
Entity Type:Organization
Organization Name:JAY R OWENS JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-666-5412
Mailing Address - Street 1:1123 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 714
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1650
Mailing Address - Country:US
Mailing Address - Phone:501-666-5412
Mailing Address - Fax:501-975-6261
Practice Address - Street 1:1123 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 714
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1650
Practice Address - Country:US
Practice Address - Phone:501-666-5412
Practice Address - Fax:501-975-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR20901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty