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Organization
PAGE DENTAL CENTER
Active
Organization
PAGE DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S GIFFORD DMD (PRESIDENT)
(928) 645-3206
Entity
Organization
Contact information
Practice address
112 SIXTH AVENUE, PAGE, AZ 86040-1956
(928) 645-3206
(928) 645-9139
Mailing address
PO BOX 1956, 112 SIXTH AVENUE, PAGE, AZ 86040-1956
(928) 645-3206
(928) 645-9139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3440
AZ
1223G0001X
General Practice Dentistry
5411
AZ
1223G0001X
General Practice Dentistry
Primary
7427
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084004
—
AZ
05
—
086274
—
AZ
05
—
283845
—
AZ
Enumeration date
05/19/2008
Last updated
12/17/2008
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