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Contact Information

ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A
3003 TWIN RIVERS DR
ARKADELPHIA, AR71923-4219
 Phone: 870-246-2242
 Fax: 870-246-2495
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A

NPI # 1740435312
LBN Legal business name ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A
Authorized official HANNAH FISH - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 11/24/2008
Last updated 05/10/2019 - About 7 years ago
Identifiers
AR License # 2256
AR Medicaid 172175631
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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