Provider Demographics
NPI:1780839589
Name:PATTI J. MULLINS, DDS, PA
Entity Type:Organization
Organization Name:PATTI J. MULLINS, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-523-5483
Mailing Address - Street 1:1307 HIGHWAY 367 N
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-2511
Mailing Address - Country:US
Mailing Address - Phone:870-523-5483
Mailing Address - Fax:870-217-0486
Practice Address - Street 1:1307 HIGHWAY 367 N
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-0279
Practice Address - Country:US
Practice Address - Phone:870-523-5483
Practice Address - Fax:870-217-0486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty