Provider Demographics
NPI:1366605081
Name:INMAN DENTAL CLINIC
Entity type:Organization
Organization Name:INMAN DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-552-3500
Mailing Address - Street 1:PO BOX N
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:AR
Mailing Address - Zip Code:72024-1514
Mailing Address - Country:US
Mailing Address - Phone:870-552-3500
Mailing Address - Fax:870-552-3961
Practice Address - Street 1:513 N WILLIAMS
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:AR
Practice Address - Zip Code:72024
Practice Address - Country:US
Practice Address - Phone:870-552-3500
Practice Address - Fax:870-552-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR26781223G0001X
AR28031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty