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Organization
PAYSON DENTAL CARE PC
Active
Organization
PAYSON DENTAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MULLINS (OFFICE MANAGER)
(928) 474-2200
Entity
Organization
Contact information
Practice address
13825 N NORTHSIGHT BLVD STE 120, SCOTTSDALE, AZ 85260-3684
(480) 767-8400
Mailing address
315 E ST HWY 260, PAYSON, AZ 85541-4930
(928) 474-2200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Enumeration date
05/02/2019
Last updated
01/18/2024
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