Provider Demographics
NPI:1740344944
Name:DEEMS, DONALD ARTHUR III (DDS)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:ARTHUR
Last Name:DEEMS
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12921 CANTRELL ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1701
Mailing Address - Country:US
Mailing Address - Phone:501-664-3279
Mailing Address - Fax:201-664-5392
Practice Address - Street 1:12921 CANTRELL ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1701
Practice Address - Country:US
Practice Address - Phone:501-664-3279
Practice Address - Fax:201-664-5392
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR28061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR58042OtherBCBS AR PROVIDE ARKANSAS
AR58042OtherBCBS AR PROVIDE ARKANSAS