# LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699792788
- **Authorized official:** MRS. BETTY ANN HORN (ADMINISTRATIVE DIRECTOR)
- **Authorized official phone:** (928) 855-5041

## Contact information

- **Practice address:** 1939 MCCULLOCH BLVD N, STE 2, LAKE HAVASU CITY, AZ 86403-5652
- **Practice address phone:** (928) 855-5041
- **Practice address fax:** (928) 855-2757
- **Mailing address:** 1939 MCCULLOCH BLVD, \#2, LAKE HAVASU CITY, AZ 86403
- **Mailing address phone:** (928) 855-5041
- **Mailing address fax:** (928) 855-2757

## Taxonomy

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

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 07/21/2022