Provider Demographics
NPI:1376663872
Name:DANIEL C HEARD DDS PA
Entity Type:Organization
Organization Name:DANIEL C HEARD DDS PA
Other - Org Name:CENTRAL ARKANSAS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CARY
Authorized Official - Last Name:HEARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-753-2244
Mailing Address - Street 1:2400 CRESTWOOD RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6861
Mailing Address - Country:US
Mailing Address - Phone:501-753-2244
Mailing Address - Fax:501-753-9244
Practice Address - Street 1:2400 CRESTWOOD RD
Practice Address - Street 2:SUITE 205
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6861
Practice Address - Country:US
Practice Address - Phone:501-753-2244
Practice Address - Fax:501-753-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR162152631Medicaid