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Contact Information

ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A
5500 W MARKHAM ST
LITTLE ROCK, AR72205-3412
 Phone: 501-664-6888
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

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

NPI Number 1114479136
LBN Legal business name ARKANSAS DENTAL PROFESSIONALS, MONGRAIN, P.A
Authorized official CASSANDR TEUTSCH - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/25/2016
Last updated 10/25/2016 - About 10 years ago
Identifiers n/a
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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