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:
Health care specialties
| Specialty | Code | License # | 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 19 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 | 1043396823 | NPPES |
| Arkansas | Other | 58313 | BLUE CROSS BLUE SHIELD |
| Arkansas | Other | 842508 | BLUE CROSS BLUE SHIELD |
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