| J. Brett Mangum Dds Pc | |
|
1767 Willow Creek Rd Prescott AZ 86301-1154 | |
| (928) 778-4110 | |
| (928) 778-4114 |
| Full Name | J. Brett Mangum Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1767 Willow Creek Rd, Prescott, Arizona |
| Authorized Official Name and Position | Joseph Brett Mangum (PRESIDENT) |
| Authorized Official Contact | 9287784110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Brett Mangum Dds Pc 1767 Willow Creek Rd Prescott AZ 86301-1154 Ph: (928) 778-4110 | J. Brett Mangum Dds Pc 1767 Willow Creek Rd Prescott AZ 86301-1154 Ph: (928) 778-4110 |
| NPI Number | 1558433524 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558433524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D5563 (Arizona) | Primary |
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