Roark, Rodney Joe

Roark, Rodney Joe is an individual health care provider with primary practice located at 4102 N Mall Ave , Fayetteville AR 72703-4911. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Roark, Rodney Joe can be contacted via phone (479) 442-2424.

Contact Information

Primary practice address
4102 N Mall Ave Fayetteville AR 72703-4911
Phone: (479) 442-2424
Fax: (479) 442-9325
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3136 Arkansas

Profile Details

NPI number 1407905698
LBN Legal business name Roark, Rodney Joe
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407905698 NPPES
Arkansas Other 3136 LISCENSE NUMBER

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