Provider Demographics
NPI:1396923371
Name:WILLIAM L. EGGART, JR, DDS, PA
Entity type:Organization
Organization Name:WILLIAM L. EGGART, JR, DDS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:EGGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-354-8800
Mailing Address - Street 1:9 MEDICAL SERVICES DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-4528
Mailing Address - Country:US
Mailing Address - Phone:501-354-8800
Mailing Address - Fax:501-354-8801
Practice Address - Street 1:9 MEDICAL SERVICES DR
Practice Address - Street 2:SUITE A
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-4528
Practice Address - Country:US
Practice Address - Phone:501-354-8800
Practice Address - Fax:501-354-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR152718608Medicaid
AR1579726OtherUNITED CONCORDIA
AR5X712OtherBCBS