Thomas Donovan Kiefer, DDS
Individual provider Active NPI General Practice Dentistry · Ratcliff, AR
NPI 1750857066 · NPPES record last updated Oct 15, 2018
Key facts
- NPI
- 1750857066
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4317 (AR)
- Practice address
- 9755 W State Highway 22
Ratcliff, AR 72951-9000 - Phone
- (479) 635-5300
- NPI assigned
- Oct 15, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4317 | AR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Valley Primary Care Services Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4317 | AR | Yes |
Addresses
Primary practice location
9755 W State Highway 22
Ratcliff, AR 72951-9000
Mailing address
1119 Springhill Rd Unit B
Barling, AR 72923-2468
Phone (479) 438-0711
Other providers in Ratcliff, AR
- Wendy A. Gaston
- Michael L Guyer
- Lauren Ashley Hall
- John Benjamin Jacobs
- Charles Woodrow Jones Jr.
- Glenda Marie King
- Jonathan James Larsen
- Charles D Parker
- April Revis
- River Valley Primary Care Services
All providers in Ratcliff, AR · General Practice Dentistry in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.