| Oral And Facial Surgery Center Of Prescott | |
|
5415 Distiction Way Prescott AZ 86301 | |
| (205) 470-0047 | |
| Not Available |
| Full Name | Oral And Facial Surgery Center Of Prescott |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 5415 Distiction Way, Prescott, Arizona |
| Authorized Official Name and Position | Benjamin Abt (OWNER/PROVIDER) |
| Authorized Official Contact | 2054700047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral And Facial Surgery Center Of Prescott 5415 Distiction Way Prescott AZ 86301 Ph: () - | Oral And Facial Surgery Center Of Prescott 5415 Distiction Way Prescott AZ 86301 Ph: (205) 470-0047 |
| NPI Number | 1275925265 |
|---|---|
| Provider Enumeration Date | 02/27/2015 |
| Last Update Date | 07/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275925265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 8911 (Arizona) | Primary |
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