Individual ProviderJon C VammenDentistDental ProvidersPractice Address1219 Front Street, Conway, AR 72032-4101(501) 329-3312PECOS EnrollmentBased on the most recent information from CMS, provider Jon C Vammen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1215153788Provider TypeIndividualFull NameVammen, Jon CTitleDr.CredentialDDSGenderMaleSole ProprietorNoEnumeration Date4/17/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address1219 Front Street, Conway, AR 72032-4101Phone(501) 329-3312Fax(501) 329-0576Mailing LocationMailing Address1219 Front Street, Conway, AR 72032-4101Phone(501) 329-3312Fax(501) 329-0576Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseAR2420Arkansas