Provider Demographics
NPI:1588780688
Name:JOHN DEAN, D.D.S., P.A.
Entity type:Organization
Organization Name:JOHN DEAN, D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RDH
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:501-837-4189
Mailing Address - Street 1:2524 CRESTWOOD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7648
Mailing Address - Country:US
Mailing Address - Phone:501-771-2911
Mailing Address - Fax:501-758-2078
Practice Address - Street 1:2524 CRESTWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7648
Practice Address - Country:US
Practice Address - Phone:501-771-2911
Practice Address - Fax:501-758-2078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR31181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty