Provider Demographics
NPI:1023171808
Name:LANDRY, CYNTHIA A (DDS)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:LANDRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:LEPANTO
Mailing Address - State:AR
Mailing Address - Zip Code:72354-2425
Mailing Address - Country:US
Mailing Address - Phone:870-475-2573
Mailing Address - Fax:870-475-2558
Practice Address - Street 1:503 MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:LEPANTO
Practice Address - State:AR
Practice Address - Zip Code:72354-2425
Practice Address - Country:US
Practice Address - Phone:870-475-2573
Practice Address - Fax:870-475-2558
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist