Individual
DR. YAKOV KHAYDATOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5225 N 19TH AVE, SUITE C, PHOENIX, AZ 85015-2903
(602) 433-0313
Mailing address
110 E JOAN D ARC AVE, PHOENIX, AZ 85022-4705
(602) 367-8456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7845
AZ
Other
Enumeration date
08/03/2009
Last updated
12/03/2009
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