Provider Demographics
NPI:1972196897
Name:LANCE A. MCGRAW, D.D.S., PLLC
Entity Type:Organization
Organization Name:LANCE A. MCGRAW, D.D.S., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-882-3835
Mailing Address - Street 1:1010 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-3165
Mailing Address - Country:US
Mailing Address - Phone:501-882-3835
Mailing Address - Fax:501-882-0535
Practice Address - Street 1:1010 W CENTER ST
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-3165
Practice Address - Country:US
Practice Address - Phone:501-882-3835
Practice Address - Fax:501-882-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty