Renegar, Gary
Renegar, Gary is an sole proprietor health care provider with primary practice located at 1831 N Green Acres Rd , Fayetteville AR 72703-2615. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Renegar, Gary can be contacted via phone (479) 521-6400.Contact Information
Primary practice address
1831 N Green Acres Rd
Fayetteville AR 72703-2615
Phone: (479) 521-6400
Fax: (479) 521-0164
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 1942 | Arkansas |
Profile Details
| NPI number | 1326145350 |
|---|---|
| LBN Legal business name | Renegar, Gary |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1326145350 | NPPES |
| Arkansas | Other | 58605 | BLUE CROSS BLUE SHIELD |
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