Provider Demographics
NPI:1922559483
Name:REESE LUNSFORD DDS PLLC
Entity Type:Organization
Organization Name:REESE LUNSFORD DDS PLLC
Other - Org Name:ASHDOWN DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:REESE
Authorized Official - Last Name:LUNSFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-898-5077
Mailing Address - Street 1:370 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHDOWN
Mailing Address - State:AR
Mailing Address - Zip Code:71822-2750
Mailing Address - Country:US
Mailing Address - Phone:870-898-5077
Mailing Address - Fax:870-898-2070
Practice Address - Street 1:370 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822-2750
Practice Address - Country:US
Practice Address - Phone:870-898-5077
Practice Address - Fax:870-898-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4062122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty