Provider Demographics
NPI:1659517910
Name:CARL N OVERCASH
Entity Type:Organization
Organization Name:CARL N OVERCASH
Other - Org Name:CARL N OVERCASH, DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:NORVIN
Authorized Official - Last Name:OVERCASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-734-4722
Mailing Address - Street 1:105 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BRINKLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72021-3207
Mailing Address - Country:US
Mailing Address - Phone:870-734-4722
Mailing Address - Fax:870-734-3236
Practice Address - Street 1:105 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:BRINKLEY
Practice Address - State:AR
Practice Address - Zip Code:72021-3207
Practice Address - Country:US
Practice Address - Phone:870-734-4722
Practice Address - Fax:870-734-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2584261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental