Organization
COTTONWOOD DENTAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE EDWIN WESTOVER DDS (OWNER/DENTIST)
(928) 634-5566
Entity
Organization
Contact information
Practice address
830 S MAIN ST, SUITE 1 D, COTTONWOOD, AZ 86326-4620
(928) 634-5566
(928) 634-1363
Mailing address
830 S MAIN ST, SUITE 1 D, COTTONWOOD, AZ 86326-4620
(928) 634-5566
(928) 634-1363
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D03477
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659573087
INDIVIDUAL NPI
AZ
01
—
D03477
DENTAL LICENSE
AZ
Enumeration date
02/04/2016
Last updated
02/04/2016
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