# ORAL AND FACIAL SURGERY CENTER OF PRESCOTT

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

## Provider details

- **NPI number:** 1275925265
- **Authorized official:** BENJAMIN ABT DMD (OWNER/PROVIDER)
- **Authorized official phone:** (205) 470-0047

## Contact information

- **Practice address:** 5415 DISTICTION WAY, PRESCOTT, AZ 86301
- **Practice address phone:** (205) 470-0047
- **Mailing address:** 5415 DISTICTION WAY, PRESCOTT, AZ 86301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 8911 | AZ | Yes |

## Other

- **Enumeration date:** 02/27/2015
- **Last updated:** 07/23/2015