Organization
TRICITY DENTAL
Active
Other names
Distinctive Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL JUAN WULFF D.M.D (OWNER)
(928) 445-3181
Entity
Organization
Contact information
Practice address
1000 WILLOW CREEK RD, SUITE H, PRESCOTT, AZ 86301-1645
(928) 445-3181
(928) 445-5797
Mailing address
1000 WILLOW CREEK RD, SUITE H, PRESCOTT, AZ 86301-1645
(928) 445-3181
(928) 445-5797
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D3674
AZ
Other
Enumeration date
06/18/2008
Last updated
06/18/2008
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