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Organization

ORAL AND FACIAL SURGERY CENTER OF PRESCOTT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN ABT DMD (OWNER/PROVIDER)
(205) 470-0047
Entity
Organization

Contact information

Practice address
5415 DISTICTION WAY, PRESCOTT, AZ 86301
(205) 470-0047
Mailing address
5415 DISTICTION WAY, PRESCOTT, AZ 86301

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8911
AZ

Other

Enumeration date
02/27/2015
Last updated
07/23/2015
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