Provider Demographics
NPI:1821279134
Name:METROPARK DENTAL ARTS
Entity Type:Organization
Organization Name:METROPARK DENTAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENBEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-845-1191
Mailing Address - Street 1:508 S 52ND ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8600
Mailing Address - Country:US
Mailing Address - Phone:479-845-1191
Mailing Address - Fax:
Practice Address - Street 1:508 S 52ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8600
Practice Address - Country:US
Practice Address - Phone:479-845-1191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR108121OtherUNITED CONCORDIA
AR56542OtherARKANSAS BCBS