Provider Demographics
NPI:1669085155
Name:CARMEN P. NUGENT, D.D.D., P.A
Entity type:Organization
Organization Name:CARMEN P. NUGENT, D.D.D., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NUGENT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-636-6660
Mailing Address - Street 1:1012 W POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-4242
Mailing Address - Country:US
Mailing Address - Phone:479-636-6660
Mailing Address - Fax:479-636-6426
Practice Address - Street 1:1012 W POPLAR ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-4242
Practice Address - Country:US
Practice Address - Phone:479-636-6660
Practice Address - Fax:479-636-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental