| Vallejo Dental Pllc | |
|
12075 E State Route 69 Ste 9 Dewey AZ 86327-4517 | |
| (928) 277-0142 | |
| (928) 277-0151 |
| Full Name | Vallejo Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12075 E State Route 69 Ste 9, Dewey, Arizona |
| Authorized Official Name and Position | Loni Vallejo (OWNER) |
| Authorized Official Contact | 9282770142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vallejo Dental Pllc 12075 E State Route 69 Ste 9 Dewey AZ 86327-4517 Ph: (928) 277-0142 | Vallejo Dental Pllc 12075 E State Route 69 Ste 9 Dewey AZ 86327-4517 Ph: (928) 277-0142 |
| NPI Number | 1033572128 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 04/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033572128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7078 (Arizona) | Primary |
Our Family Dentist-dewey Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S State Route 69, Suite 5f, Dewey, AZ 86327 Phone: 928-632-8333 Fax: 928-632-5537 |