Provider Demographics
NPI:1982958450
Name:PR8ZEL LLC
Entity Type:Organization
Organization Name:PR8ZEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRAETZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:5016-234-4858
Mailing Address - Street 1:200 MCAULEY CT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6312
Mailing Address - Country:US
Mailing Address - Phone:501-623-4485
Mailing Address - Fax:501-623-4480
Practice Address - Street 1:208 MCAULEY CT
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6312
Practice Address - Country:US
Practice Address - Phone:501-623-9200
Practice Address - Fax:501-623-9204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3759261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical