Individual
FORREST JOHN PRATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2979 W ELLIOT RD STE 4, CHANDLER, AZ 85224-1641
(480) 775-1304
Mailing address
2979 W ELLIOT RD STE 4, CHANDLER, AZ 85224-1641
(480) 775-1304
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D010864
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184156127
—
AZ
Enumeration date
03/29/2017
Last updated
08/08/2022
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