Provider Demographics
NPI:1609158153
Name:DRS. NATHANIEL AND KATHERINE BEHRENTS DDS, PC
Entity Type:Organization
Organization Name:DRS. NATHANIEL AND KATHERINE BEHRENTS DDS, PC
Other - Org Name:BEHRENTS ENDODONTIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHRENTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:901-277-5099
Mailing Address - Street 1:152 E APPLEBY RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3903
Mailing Address - Country:US
Mailing Address - Phone:901-277-5099
Mailing Address - Fax:479-445-6942
Practice Address - Street 1:152 E APPLEBY RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3903
Practice Address - Country:US
Practice Address - Phone:901-277-5099
Practice Address - Fax:479-445-6942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR38191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty