Basic Information
| Provider Information | |||||||||
| NPI: | 1932852910 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMS | ||||||||
| FirstName: | MI | ||||||||
| MiddleName: | SUK | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | I | ||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6976 OLD CUSSETA RD BLDG 4202 | ||||||||
| Address2: | |||||||||
| City: | FORT BENNING | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319055431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065443176 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6976 OLD CUSSETA RD BLDG 4202 | ||||||||
| Address2: | |||||||||
| City: | FORT BENNING | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319055431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065443176 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2022 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 126800000X | Y | Dental Providers | Dental Assistant |
No ID Information.