# PAYSON DENTAL CARE PC

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

## Provider details

- **NPI number:** 1811552128
- **Authorized official:** JENNIFER MULLINS (OFFICE MANAGER)
- **Authorized official phone:** (928) 474-2200

## Contact information

- **Practice address:** 13825 N NORTHSIGHT BLVD STE 120, SCOTTSDALE, AZ 85260-3684
- **Practice address phone:** (480) 767-8400
- **Mailing address:** 315 E ST HWY 260, PAYSON, AZ 85541-4930
- **Mailing address phone:** (928) 474-2200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 05/02/2019
- **Last updated:** 01/18/2024