Provider Demographics
NPI:1417565482
Name:SIZEMORE, RACHEL WALTERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:WALTERS
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEIGHANN
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:RATCLIFF
Mailing Address - State:AR
Mailing Address - Zip Code:72951-0130
Mailing Address - Country:US
Mailing Address - Phone:479-431-2057
Mailing Address - Fax:
Practice Address - Street 1:437 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:AR
Practice Address - Zip Code:72947-8574
Practice Address - Country:US
Practice Address - Phone:479-279-7672
Practice Address - Fax:479-279-7673
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR44811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice