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Organization
LAKE HAVASU DENTISTRY
Active
Organization
LAKE HAVASU DENTISTRY
Active
Other names
Havasu Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA VAUGHN (MANAGER)
(928) 733-6070
Entity
Organization
Contact information
Practice address
1971 MCCULLOCH BLVD N, #100, LAKE HAVASU CITY, AZ 86403-6117
(928) 733-6070
(928) 733-6075
Mailing address
1971 MCCULLOCH BLVD N, #100, LAKE HAVASU CITY, AZ 86403-6117
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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