Provider Demographics
NPI:1538363353
Name:CENTRAL ARKANSAS DENTAL ASSOCIATES
Entity type:Organization
Organization Name:CENTRAL ARKANSAS DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:ORR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-676-6770
Mailing Address - Street 1:7249 GAP RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-3688
Mailing Address - Country:US
Mailing Address - Phone:870-897-6141
Mailing Address - Fax:
Practice Address - Street 1:123 N CENTER ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-2805
Practice Address - Country:US
Practice Address - Phone:501-676-6770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty