Provider Demographics
NPI:1851025738
Name:PINKERTON, JACOB BRYCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:BRYCE
Last Name:PINKERTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 NARROWS RD
Mailing Address - Street 2:
Mailing Address - City:LONSDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72087-9460
Mailing Address - Country:US
Mailing Address - Phone:501-909-2093
Mailing Address - Fax:
Practice Address - Street 1:4909 HIGHWAY 5 N STE 700
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-7075
Practice Address - Country:US
Practice Address - Phone:501-847-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist