Provider Demographics
NPI:1952502601
Name:ANITA L. AEBERSOLD, DDS PA
Entity Type:Organization
Organization Name:ANITA L. AEBERSOLD, DDS PA
Other - Org Name:AEBERSOLD FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:AEBERSOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-664-1733
Mailing Address - Street 1:820 N. UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-664-1733
Mailing Address - Fax:501-664-1759
Practice Address - Street 1:820 N. UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-664-1733
Practice Address - Fax:501-664-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty