Provider Demographics
NPI:1497447197
Name:HYSER, KIRSTAN LEIGH (DDS)
Entity Type:Individual
Prefix:
First Name:KIRSTAN
Middle Name:LEIGH
Last Name:HYSER
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 1:17200 CHENAL PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-5958
Mailing Address - Country:US
Mailing Address - Phone:501-448-0032
Mailing Address - Fax:501-448-0068
Practice Address - Street 1:17200 CHENAL PKWY STE 250
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-5958
Practice Address - Country:US
Practice Address - Phone:501-448-0032
Practice Address - Fax:501-448-0068
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR46631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice