Provider Demographics
NPI:1598801268
Name:DENSON-MEANS, ANDREA M (MS, DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:M
Last Name:DENSON-MEANS
Suffix:
Gender:F
Credentials:MS, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:FORREST CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72336-0999
Mailing Address - Country:US
Mailing Address - Phone:404-242-7543
Mailing Address - Fax:
Practice Address - Street 1:420 E COOK ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-2869
Practice Address - Country:US
Practice Address - Phone:870-633-4894
Practice Address - Fax:870-633-4965
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0120501223G0001X
AR35571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice