Provider Demographics
NPI:1669064713
Name:OZARK PROS LITTLE ROCK
Entity type:Organization
Organization Name:OZARK PROS LITTLE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MCNEEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-319-7520
Mailing Address - Street 1:8028 CANTRELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2419
Mailing Address - Country:US
Mailing Address - Phone:501-319-7520
Mailing Address - Fax:
Practice Address - Street 1:8028 CANTRELL RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2419
Practice Address - Country:US
Practice Address - Phone:501-319-7520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty