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Organization

KINGMAN DENTAL PROFESSIONALS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN LUNDGREEN (MEMBER/CEO)
(480) 295-9234
Entity
Organization

Contact information

Practice address
3775 N STOCKTON HILL RD, KINGMAN, AZ 86409-3219
(480) 295-9234
Mailing address
7205 E SOUTHERN AVE STE A-122, MESA, AZ 85209-2790
(480) 295-9234

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
08/21/2020
Last updated
08/21/2020
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