Tacy Marie Sundell in Little Rock - Periodontics
Tacy Marie Sundell - NPI 1689687584
Tacy Marie Sundell is a Periodontics in Little Rock, Arkansas. Tacy Marie Sundell practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Tacy Marie Sundell is 1689687584. The last update date is 2007-07-08.
Tacy Marie Sundell's current location address is 11300 Cantrell Rd Ste 303, Little Rock, Arkansas. You can contact this provider via phone number 5012285700. The mailing address for Tacy Marie Sundell is 11300 Cantrell Rd Ste 303, Little Rock, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tacy Marie Sundell |
|---|---|
| Address | 11300 Cantrell Rd Ste 303, Little Rock, Arkansas |
| Phone Number | 5012285700 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1689687584 |
|---|---|
| Provider Enumeration Date | 2006-08-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 11300 Cantrell Rd Ste 303 |
|---|---|
| City | Little Rock |
| State | Arkansas (AR) |
| Post Code | 722121844 |
| Phone Number | 5012285700 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 3352 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1493112 | AR | UNITED CONCORDIA | |
| 5X406 | AR | BLUE CROSS PROVIDER NUMBE |
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What is the unique 10-digit identifier code assigned to Tacy Marie Sundell by the Centers for Medicare & Medicaid Services?
The Tacy Marie Sundell has been issued the NPI (National Provider Identifier) 1689687584 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Tacy Marie Sundell's physical address?
The Tacy Marie Sundell is physically located at 11300 Cantrell Rd Ste 303, in the city of Little Rock, AR, with the postal code 722121844.
What is Tacy Marie Sundell's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Tacy Marie Sundell's specialized field of practice is Periodontics, and the corresponding taxonomy code that categorizes this area of specialization is 1223P0300X.
When did Tacy Marie Sundell receive its 1689687584 assignment?
The Tacy Marie Sundell was assigned its 1689687584 on 2006-08-14, which is the date when this unique identifier was issued to the organization.
As of what date were the Tacy Marie Sundell's details last updated?
The information pertaining to the Tacy Marie Sundell, including its address, specialty, and other details, was most recently updated on 2007-07-08.
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