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Organization
BLUE RIDGE FAMILY DENTISTRY, PC
Active
Organization
BLUE RIDGE FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN HANRIDGE DDS (PRESIDENT, BRFD, PC)
(928) 367-4466
Entity
Organization
Contact information
Practice address
1450 E WHITE MOUNTAIN BLVD STE A, PINETOP, AZ 85935-7091
(928) 367-4466
Mailing address
PO BOX 3768, PINETOP, AZ 85935-3768
(928) 367-4466
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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