Provider Demographics
NPI:1972005908
Name:DOVE, JAMES AUSTIN (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:AUSTIN
Last Name:DOVE
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 1:1701 CENTERVIEW DR STE 114
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4311
Mailing Address - Country:US
Mailing Address - Phone:501-386-3397
Mailing Address - Fax:
Practice Address - Street 1:400 PLAZA
Practice Address - Street 2:
Practice Address - City:WEST HELENA
Practice Address - State:AR
Practice Address - Zip Code:72390-2541
Practice Address - Country:US
Practice Address - Phone:870-338-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR26531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR2653OtherDENTAL LICENSE