Sundell, Tacy Marie

Sundell, Tacy Marie is an individual health care provider with primary practice located at 11300 Cantrell Rd Ste 303 , Little Rock AR 72212-1844. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Sundell, Tacy Marie can be contacted via phone (501) 228-5700.

Contact Information

Primary practice address
11300 Cantrell Rd Ste 303 Little Rock AR 72212-1844
Phone: (501) 228-5700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 3352 Arkansas

Profile Details

NPI number 1689687584
LBN Legal business name Sundell, Tacy Marie
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 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 1689687584 NPPES
Arkansas Other 1493112 UNITED CONCORDIA
Arkansas Other 5X406 UNITED CONCORDIA

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