Provider Demographics
NPI:1588107700
Name:ROCK SPRINGS DENTAL, PLLC
Entity type:Organization
Organization Name:ROCK SPRINGS DENTAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-741-1060
Mailing Address - Street 1:1515 ROCK SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-8804
Mailing Address - Country:US
Mailing Address - Phone:870-741-1060
Mailing Address - Fax:870-741-4713
Practice Address - Street 1:1515 ROCK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-8804
Practice Address - Country:US
Practice Address - Phone:870-741-1060
Practice Address - Fax:870-741-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-19
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental