Prairie Grove Dental Center Pllc
NPI #1508454612 in Prairie Grove, Arkansas
Provider Information
- NPI Number
- 1508454612
- Entity Type
- Organization
- Organization Name
- Prairie Grove Dental Center Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 5, 2021
- Last Updated
- Jan 5, 2021
Practice Location
- Address
- 1121 E HERITAGE PKWY
- City
- Prairie Grove
- State
- Arkansas
- ZIP Code
- 72753-6013
- Phone
- (479) 244-2052
Authorized Official
- Name
- DR. ALAN DOUGLAS CLARK, DDS
- Title
- DENTIST-OWNER
- Phone
- (479) 244-2052
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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