Provider Demographics
NPI:1376616946
Name:MULLINS, PATTI J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATTI
Middle Name:J
Last Name:MULLINS
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 1:4 SUE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112
Mailing Address - Country:US
Mailing Address - Phone:870-523-8686
Mailing Address - Fax:
Practice Address - Street 1:1307 HWY 367 N
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72117
Practice Address - Country:US
Practice Address - Phone:870-523-5483
Practice Address - Fax:870-217-0486
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist