Individual
JOE DALE DITTERLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
667 E MINGUS AVE, COTTONWOOD, AZ 86326-3760
(928) 634-7585
(928) 634-7257
Mailing address
667 E MINGUS AVE, COTTONWOOD, AZ 86326-3760
(928) 634-7585
(928) 634-7257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4395
AZ
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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