Provider Demographics
NPI:1578639167
Name:DONALD A DEEMS III DDS PA
Entity Type:Organization
Organization Name:DONALD A DEEMS III DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:DEEMS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-664-3279
Mailing Address - Street 1:12921 CANTRELL ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1701
Mailing Address - Country:US
Mailing Address - Phone:501-664-3279
Mailing Address - Fax:501-664-5392
Practice Address - Street 1:12921 CANTRELL ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1701
Practice Address - Country:US
Practice Address - Phone:501-664-3279
Practice Address - Fax:501-664-5392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty