Provider Demographics
NPI:1245048321
Name:DOVER AND HART DENTAL PLLC
Entity type:Organization
Organization Name:DOVER AND HART DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MDS
Authorized Official - Phone:870-425-4777
Mailing Address - Street 1:400 S COLLEGE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3991
Mailing Address - Country:US
Mailing Address - Phone:870-425-4777
Mailing Address - Fax:
Practice Address - Street 1:400 S COLLEGE ST STE 1
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3991
Practice Address - Country:US
Practice Address - Phone:870-425-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty