# ARIZONA DENTAL PROFESSIONALS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ARIZONA DENTAL PROFESSIONALS, P.C.
- **Other names:** Dental Village - Sierra Vista
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578966966
- **Legal business name:** ARIZONA DENTAL PROFESSIONALS, P.C.
- **Authorized official:** KIM WILSON (CRED SUPERVISOR)
- **Authorized official phone:** (217) 540-5170

## Contact information

- **Practice address:** 400 N HWY 90 BYP STE C2, SIERRA VISTA, AZ 85635-2293
- **Practice address phone:** (520) 459-2200
- **Mailing address:** 400 N HWY 90 BYP STE C2, SIERRA VISTA, AZ 85635-2293
- **Mailing address phone:** (520) 459-2200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2014
- **Last updated:** 04/12/2021