Provider Demographics
NPI:1386133155
Name:TOOTH BE TOLD PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:TOOTH BE TOLD PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-262-8118
Mailing Address - Street 1:930 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-5827
Mailing Address - Country:US
Mailing Address - Phone:870-262-8118
Mailing Address - Fax:
Practice Address - Street 1:930 15TH ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-5827
Practice Address - Country:US
Practice Address - Phone:870-208-3009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR41891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty