Provider Demographics
NPI:1558028886
Name:TRUMANN FAMILY DENTAL
Entity type:Organization
Organization Name:TRUMANN FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-483-0543
Mailing Address - Street 1:817 HIGHWAY 463 N
Mailing Address - Street 2:
Mailing Address - City:TRUMANN
Mailing Address - State:AR
Mailing Address - Zip Code:72472-1636
Mailing Address - Country:US
Mailing Address - Phone:870-483-0543
Mailing Address - Fax:870-483-0544
Practice Address - Street 1:817 HIGHWAY 463 N
Practice Address - Street 2:
Practice Address - City:TRUMANN
Practice Address - State:AR
Practice Address - Zip Code:72472-1636
Practice Address - Country:US
Practice Address - Phone:870-483-0543
Practice Address - Fax:870-483-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty