Mathis, Eric Kamaal

Mathis, Eric Kamaal is an sole proprietor health care provider with primary practice located at 26 Green Valley Dr , Mountain Home AR 72653-8102. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mathis, Eric Kamaal can be contacted via phone (870) 425-6911.

Contact Information

Primary practice address
26 Green Valley Dr Mountain Home AR 72653-8102
Phone: (870) 425-6911
Fax: (870) 424-4891
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2880 Arkansas

Profile Details

NPI number 1043396823
LBN Legal business name Mathis, Eric Kamaal
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043396823 NPPES
Arkansas Other 58313 BLUE CROSS BLUE SHIELD
Arkansas Other 842508 BLUE CROSS BLUE SHIELD

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