Provider Demographics
NPI:1710441050
Name:HOT SPRINGS ENDODONTICS BRUCE A GASTON DDS PLLC BRUCE A GASTON SOLE MB
Entity Type:Organization
Organization Name:HOT SPRINGS ENDODONTICS BRUCE A GASTON DDS PLLC BRUCE A GASTON SOLE MB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCANALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-828-9757
Mailing Address - Street 1:1911 MALVERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7753
Mailing Address - Country:US
Mailing Address - Phone:501-609-9196
Mailing Address - Fax:501-609-9148
Practice Address - Street 1:1911 MALVERN AVE STE A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7753
Practice Address - Country:US
Practice Address - Phone:501-609-9196
Practice Address - Fax:501-609-9148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty