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Organization
PRESCOTT PERIODONTICS & IMPLANT DENTISTRY, PLLC
Active
Organization
PRESCOTT PERIODONTICS & IMPLANT DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CHARLES JIRSA D.D.S, M.S. (PERIODONTIST)
(928) 778-2340
Entity
Organization
Contact information
Practice address
1229 WILLOW CREEK RD, PRESCOTT, AZ 86301-1427
(928) 778-2340
(928) 778-3646
Mailing address
1229 WILLOW CREEK RD, PRESCOTT, AZ 86301-1427
(928) 778-2340
(928) 778-3646
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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