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Organization

KKTZ DENTAL PLLC

Active
Parent organization
KKTZ DENTAL PLLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
KKTZ DENTAL PLLC
Authorized official
GAYLE JENNINGS (OFFICE MANAGER)
(928) 577-2533
Entity
Organization

Contact information

Practice address
5221 S HIGHWAY 95 STE 4, FORT MOHAVE, AZ 86426-9244
(928) 577-2533
(928) 577-2518
Mailing address
5221 S HIGHWAY 95 STE 4, FORT MOHAVE, AZ 86426-9244
(928) 577-2533
(928) 577-2518

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
01/09/2019
Last updated
01/09/2019
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