Organization
ADVANCED DENTISTRYPLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT A HALES I DDS (OWNER)
(520) 458-9460
Entity
Organization
Contact information
Practice address
1236 E FRY BLVD, SIERRA VISTA, AZ 85635-2602
(520) 458-9460
(520) 458-9461
Mailing address
1236 E FRY BLVD, SIERRA VISTA, AZ 85635-2602
(520) 458-9460
(520) 458-9461
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4943
AZ
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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