Provider Demographics
NPI:1508223827
Name:THOMAS A. SARNA, DDS PLLC
Entity Type:Organization
Organization Name:THOMAS A. SARNA, DDS PLLC
Other - Org Name:HALF MOON ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:SARNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-202-8666
Mailing Address - Street 1:2025 N GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2619
Mailing Address - Country:US
Mailing Address - Phone:479-202-8666
Mailing Address - Fax:844-315-4115
Practice Address - Street 1:2025 N GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2619
Practice Address - Country:US
Practice Address - Phone:479-202-8666
Practice Address - Fax:844-315-4115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR85261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR206251679Medicaid