| Jeffrey C Wight Dds Pllc | |
|
4135 S Power Rd Ste 101 Mesa AZ 85212-3625 | |
| (480) 588-2188 | |
| Not Available |
| Full Name | Jeffrey C Wight Dds Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4135 S Power Rd Ste 101, Mesa, Arizona |
| Authorized Official Name and Position | Jeffrey Wight (OWNER-PROVIDER) |
| Authorized Official Contact | 4805882188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey C Wight Dds Pllc 4135 S Power Rd Ste 101 Mesa AZ 85212-3625 Ph: (480) 588-2188 | Jeffrey C Wight Dds Pllc 4135 S Power Rd Ste 101 Mesa AZ 85212-3625 Ph: (480) 588-2188 |
| NPI Number | 1174241053 |
|---|---|
| Provider Enumeration Date | 08/17/2022 |
| Last Update Date | 08/17/2022 |
| Medicare PECOS PAC ID | 3870978646 |
|---|---|
| Medicare Enrollment ID | O20220914002065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174241053 | NPI | - | NPPES |
| D07838 | Other | AZ | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X2210X | Dentist - Orofacial Pain | (* (Not Available)) | Primary |
| Provider Name | Jeffrey C Wight |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043541907 PECOS PAC ID: 1052734431 Enrollment ID: I20200701001759 |
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