Kitchens, Clovis Andrew
Kitchens, Clovis Andrew is an sole proprietor health care provider with primary practice located at 14114 Taylor Loop Rd , Little Rock AR 72223. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Kitchens, Clovis Andrew can be contacted via phone (501) 868-3331.Contact Information
Primary practice address
14114 Taylor Loop Rd
Little Rock AR 72223
Phone: (501) 868-3331
Fax: (501) 868-5323
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 2186 | Arkansas |
Profile Details
| NPI number | 1336298066 |
|---|---|
| LBN Legal business name | Kitchens, Clovis Andrew |
| Credentials | D.D.S. M.S |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 10th, 2007 |
| Last updated | Dec 28th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336298066 | NPPES |
| Arkansas | Other | 58373 | BCBS ID # |
| Arkansas | MEDICAID | 156309631 | BCBS ID # |
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