Individual
DR. JUSTIN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2540 S 4TH AVE, YUMA, AZ 85364-7286
(480) 206-0139
Mailing address
2540 S 4TH AVE, YUMA, AZ 85364-7286
(480) 206-0139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 7892
AZ
Other
Enumeration date
09/03/2009
Last updated
11/04/2010
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