| Kingman Dental Professionals, Llc | |
|
3775 N Stockton Hill Rd Kingman AZ 86409-3219 | |
| (480) 295-9234 | |
| Not Available |
| Full Name | Kingman Dental Professionals, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3775 N Stockton Hill Rd, Kingman, Arizona |
| Authorized Official Name and Position | John Lundgreen (MEMBER/CEO) |
| Authorized Official Contact | 4802959234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingman Dental Professionals, Llc 7205 E Southern Ave Ste A-122 Mesa AZ 85209-2790 Ph: (480) 295-9234 | Kingman Dental Professionals, Llc 3775 N Stockton Hill Rd Kingman AZ 86409-3219 Ph: (480) 295-9234 |
| NPI Number | 1144832940 |
|---|---|
| Provider Enumeration Date | 08/21/2020 |
| Last Update Date | 08/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144832940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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