# MANGELSDORF FAMILY DENTISTRY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174707772
- **Authorized official:** DR. TIMOTHY WILLIAM MANGELSDORF D.D.S. (DENTIST)
- **Authorized official phone:** (928) 718-2136

## Contact information

- **Practice address:** 2249 HUALAPAI MOUNTAIN RD STE A, KINGMAN, AZ 86401-8321
- **Practice address phone:** (928) 718-2136
- **Practice address fax:** (928) 718-2137
- **Mailing address:** 2249 HUALAPAI MOUNTAIN RD STE A, KINGMAN, AZ 86401-8321
- **Mailing address phone:** (928) 718-2136
- **Mailing address fax:** (928) 718-2137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 3751 | AZ | Yes |

## Other

- **Enumeration date:** 12/19/2007
- **Last updated:** 12/19/2007