| Tri-states Dental, Inc. | |
|
1518 Sierra Vista Dr Bullhead City AZ 86442-6069 | |
| (928) 704-0144 | |
| (928) 704-9791 |
| Full Name | Tri-states Dental, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1518 Sierra Vista Dr, Bullhead City, Arizona |
| Authorized Official Name and Position | Dominic Do (CFO) |
| Authorized Official Contact | 9287040144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-states Dental, Inc. 1518 Sierra Vista Dr Bullhead City AZ 86442-6069 Ph: (928) 704-0144 | Tri-states Dental, Inc. 1518 Sierra Vista Dr Bullhead City AZ 86442-6069 Ph: (928) 704-0144 |
| NPI Number | 1649460221 |
|---|---|
| Provider Enumeration Date | 07/30/2007 |
| Last Update Date | 07/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649460221 | NPI | - | NPPES |
| 190343 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4817 (Nevada) | Primary |
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