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Organization
PINEVIEW PRESCOTT DENTAL
Active
Organization
PINEVIEW PRESCOTT DENTAL
Active
Parent organization
PINEVIEW PRESCOTT DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINEVIEW PRESCOTT DENTAL
Authorized official
DR. KENNETH GLASS DDS. (OWNER/DOCTOR)
(928) 445-9233
Entity
Organization
Contact information
Practice address
680 GAIL GARDNER WAY, PRESCOTT, AZ 86305-0001
(928) 445-9233
(928) 445-1758
Mailing address
680 GAIL GARDNER WAY, PRESCOTT, AZ 86305-0001
(928) 445-9233
(928) 445-1758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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