Congo Dental, PLLC
Clinic/Center in Benton, AR. Organization (NPI-2).
NPI number1295423192
StatusActive
Last updated in NPPESApr 27, 2023
Details
- NPI
- 1295423192
- Entity type
- Organization (NPI-2)
- Legal business name
- Congo Dental, PLLC
- Organization subpart
- No
- Enumeration date
- Apr 27, 2023
- Certification date
- Apr 27, 2023
- Last updated
- Apr 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Other names
- Congo Dental Studio (Doing Business As)
Practice location
2101 Congo Rd Ste CBenton, AR 72015-2703
Phone 501-778-1400 · Fax 501-778-6194
Mailing address
2101 Congo Rd Ste CBenton, AR 72015-2703
Phone 501-778-1400 · Fax 501-778-6194
Authorized official
Tracy Marie Schroepfer
Dentist
5017781400
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