Provider Demographics
NPI:1770607137
Name:DEAN, JOHN HAMILTON (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HAMILTON
Last Name:DEAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2524 CRESTWOOD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7648
Mailing Address - Country:US
Mailing Address - Phone:501-771-2911
Mailing Address - Fax:501-758-2078
Practice Address - Street 1:2524 CRESTWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7648
Practice Address - Country:US
Practice Address - Phone:501-771-2911
Practice Address - Fax:501-758-2078
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3118332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies