Provider Demographics
NPI:1619069432
Name:HAROLD R. ARTHUR, DMD, PA
Entity Type:Organization
Organization Name:HAROLD R. ARTHUR, DMD, PA
Other - Org Name:HAROLD ARTHUR FAMILY DENTISTRY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-330-5181
Mailing Address - Street 1:1009 11TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-3605
Mailing Address - Country:US
Mailing Address - Phone:386-330-5181
Mailing Address - Fax:386-330-2320
Practice Address - Street 1:1009 11TH ST SW
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-3605
Practice Address - Country:US
Practice Address - Phone:386-330-5181
Practice Address - Fax:386-330-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN159221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty