Look up the most recent NPI and PECOS records

East Oak Dental Pa

(East Oak Dental Care)

Dentist

Dental Providers

1600 E Oak St, Ste B, Conway, AR 72032

PECOS Enrollment

Based on the most recent information from CMS, provider East Oak Dental Pa does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1083032379
Provider Type
Organization
Full Name
East Oak Dental Pa
Other Name
East Oak Dental Care

Subpart
No
Enumeration Date
4/3/2014
Last Updated
10/29/2014

Contact Information

Practice Location

1600 E Oak St, Ste B, Conway, AR 72032

(501) 358-4101

(501) 504-2545

Mailing Location

1600 E Oak St, Ste B, Conway, AR 72032

(501) 358-4101

(501) 504-2545

Authorized Official

Beck, James A (President)

(501) 358-4101

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 3769 Arkansas

East Oak Dental Pa

(East Oak Dental Care)

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Lakefront Dental Pllc

Shahare, Alaa Mohammed

Spencer Gordy Dds Pa

Jon C Vammen Dds

Fruchey, Luke

Crafton, Leo

Hambuchen, Raymond E

Simon, Greg J

Conway Regional Medical Center, Inc

Conway Dental Center Pllc