Advanced Dentistrypllc | |
1236 E Fry Blvd Sierra Vista AZ 85635-2602 | |
(520) 458-9460 | |
(520) 458-9461 |
Full Name | Advanced Dentistrypllc |
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Speciality | Dentist |
Location | 1236 E Fry Blvd, Sierra Vista, Arizona |
Authorized Official Name and Position | Kent A Hales (OWNER) |
Authorized Official Contact | 5204589460 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Advanced Dentistrypllc 1236 E Fry Blvd Sierra Vista AZ 85635-2602 Ph: (520) 458-9460 | Advanced Dentistrypllc 1236 E Fry Blvd Sierra Vista AZ 85635-2602 Ph: (520) 458-9460 |
NPI Number | 1154787778 |
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Provider Enumeration Date | 01/12/2016 |
Last Update Date | 01/12/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154787778 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | D4943 (Arizona) | Primary |
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