Paul D Baltz, DDS

Individual provider Active NPI General Practice Dentistry · Pocahontas, AR

NPI 1407076144 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1407076144
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2790 (AR)
Practice address
412 W Broadway St
Pocahontas, AR 72455-3423
Phone
(870) 892-4394
Fax
(870) 892-9089
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2790ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dental Care of Pocahontas Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2790 AR Yes

Addresses

Primary practice location

412 W Broadway St
Pocahontas, AR 72455-3423

Mailing address

412 W Broadway
Pocahontas, AR 72455
Phone (870) 892-4394

Other providers in Pocahontas, AR

All providers in Pocahontas, AR · General Practice Dentistry in Arkansas

Sources for this page

Verify at the official NPI Registry.