Provider Demographics
NPI:1720670763
Name:STEVEN SCOTT BYRD
Entity type:Organization
Organization Name:STEVEN SCOTT BYRD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-246-6745
Mailing Address - Street 1:626 CADDO ST
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-6020
Mailing Address - Country:US
Mailing Address - Phone:870-246-6745
Mailing Address - Fax:
Practice Address - Street 1:626 CADDO ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-6020
Practice Address - Country:US
Practice Address - Phone:870-246-6745
Practice Address - Fax:870-245-2431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental