| Dental Village - Sierra Vista | |
|
400 N Hwy 90 Byp Ste C2 Sierra Vista AZ 85635-2293 | |
| (520) 459-2200 | |
| Not Available |
| Full Name | Dental Village - Sierra Vista |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 N Hwy 90 Byp Ste C2, Sierra Vista, Arizona |
| Authorized Official Name and Position | Kim Wilson (CRED SUPERVISOR) |
| Authorized Official Contact | 2175405170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Village - Sierra Vista 400 N Hwy 90 Byp Ste C2 Sierra Vista AZ 85635-2293 Ph: (520) 459-2200 | Dental Village - Sierra Vista 400 N Hwy 90 Byp Ste C2 Sierra Vista AZ 85635-2293 Ph: (520) 459-2200 |
| NPI Number | 1578966966 |
|---|---|
| Provider Enumeration Date | 09/30/2014 |
| Last Update Date | 04/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578966966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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