| Biltmore Periodontics, Pllc | |
|
1277 E Missouri Ave Suite 102 Phoenix AZ 85014-2915 | |
| (602) 266-5896 | |
| (602) 274-6114 |
| Full Name | Biltmore Periodontics, Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1277 E Missouri Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Kurt D Wallin (OWNER/DENTIST) |
| Authorized Official Contact | 6022665896 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Biltmore Periodontics, Pllc 1277 E Missouri Ave Suite 102 Phoenix AZ 85014-2915 Ph: (602) 266-5896 | Biltmore Periodontics, Pllc 1277 E Missouri Ave Suite 102 Phoenix AZ 85014-2915 Ph: (602) 266-5896 |
| NPI Number | 1902252166 |
|---|---|
| Provider Enumeration Date | 05/06/2016 |
| Last Update Date | 05/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902252166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | D008400 (Arizona) | Primary |
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