Provider Demographics
NPI:1376691873
Name:BOONE, TERRY LYNN (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LYNN
Last Name:BOONE
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7197 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-3207
Mailing Address - Country:US
Mailing Address - Phone:870-267-1423
Mailing Address - Fax:870-267-1424
Practice Address - Street 1:7197 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3207
Practice Address - Country:US
Practice Address - Phone:870-267-1423
Practice Address - Fax:870-267-1424
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR23451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry