Provider Demographics
NPI:1285831016
Name:RICHARD L. SCARBROUGH, D.D.S, P.A.
Entity Type:Organization
Organization Name:RICHARD L. SCARBROUGH, D.D.S, P.A.
Other - Org Name:FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:SCARBOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-739-3600
Mailing Address - Street 1:200 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-1958
Mailing Address - Country:US
Mailing Address - Phone:870-739-3600
Mailing Address - Fax:870-739-6367
Practice Address - Street 1:200 PINE ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-1958
Practice Address - Country:US
Practice Address - Phone:870-739-3600
Practice Address - Fax:870-739-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR31381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty