Dallas Avenue Dental Care, Inc.

NPI #1255769535 in Mena, Arkansas

Provider Information

NPI Number: 1255769535
Entity Type: Organization
Organization Name: Dallas Avenue Dental Care, Inc.
Primary Specialty: Durable Medical Equipment & Medical Supplies - Customized Equipment
Enumeration Date: Oct 23, 2013
Last Updated: Oct 23, 2013

Practice Location

Address: 400 PINE AVE
City: Mena
State: Arkansas
ZIP Code: 71953-4604
Phone: (479) 394-7800

Authorized Official

Name: DR. DIANE MAROSY, D.D.S., F.A.G.D.
Title: OWNER
Phone: (479) 394-7800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X	Primary

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