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Organization
TUCSON DENTAL IMPLANTS AND PERIODONTICS PLLC
Active
Organization
TUCSON DENTAL IMPLANTS AND PERIODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK MACKELPRANG D.D.S., M.S. (MEMBER)
(310) 666-6438
Entity
Organization
Contact information
Practice address
2330 N ROSEMONT BLVD, TUCSON, AZ 85712-2163
(310) 666-6438
Mailing address
4381 N SUNSET CLIFF DR, TUCSON, AZ 85750-6934
(310) 666-6438
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D009229
AZ
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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