| Spark Dentistry Pllc | |
|
7584 E State Route 69 Prescott Valley AZ 86314-2278 | |
| (928) 499-3061 | |
| Not Available |
| Full Name | Spark Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7584 E State Route 69, Prescott Valley, Arizona |
| Authorized Official Name and Position | Simon Park (OWNER) |
| Authorized Official Contact | 9284993061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spark Dentistry Pllc Po Box 70887 Cleveland OH 44190-0887 Ph: () - | Spark Dentistry Pllc 7584 E State Route 69 Prescott Valley AZ 86314-2278 Ph: (928) 499-3061 |
| NPI Number | 1073234241 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 06/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073234241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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