Provider Demographics
NPI:1558093898
Name:CLOUD FAMILY DENTAL
Entity Type:Organization
Organization Name:CLOUD FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:KINARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-870-5008
Mailing Address - Street 1:1112 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-2909
Mailing Address - Country:US
Mailing Address - Phone:870-500-8155
Mailing Address - Fax:
Practice Address - Street 1:14922 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4248
Practice Address - Country:US
Practice Address - Phone:501-868-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental