Provider Demographics
NPI:1518517838
Name:PARIS DENTAL CLINIC PLLC
Entity Type:Organization
Organization Name:PARIS DENTAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-243-4406
Mailing Address - Street 1:100 E HUNTINGTON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-2900
Mailing Address - Country:US
Mailing Address - Phone:870-974-1577
Mailing Address - Fax:
Practice Address - Street 1:15 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:AR
Practice Address - Zip Code:72855-3205
Practice Address - Country:US
Practice Address - Phone:479-963-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty