Provider Demographics
NPI:1730664475
Name:SMILES OF ARKANSAS DENTAL CENTER, PLLC
Entity Type:Organization
Organization Name:SMILES OF ARKANSAS DENTAL CENTER, PLLC
Other - Org Name:SMILES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-777-5769
Mailing Address - Street 1:1495 W 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71857-3340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1495 W 1ST ST N
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AR
Practice Address - Zip Code:71857-3340
Practice Address - Country:US
Practice Address - Phone:870-826-1576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMILES OF ARKANSAS DENTAL CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-28
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty