Provider Demographics
NPI:1689912644
Name:DOWELL, KATHRYN (RDH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DOWELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:STAEBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:12921 CANTRELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1798
Mailing Address - Country:US
Mailing Address - Phone:501-664-3279
Mailing Address - Fax:
Practice Address - Street 1:12921 CANTRELL RD STE 101
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1798
Practice Address - Country:US
Practice Address - Phone:501-664-3279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-27
Last Update Date:2013-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2335124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist