Organization
ORAL AND FACIAL SURGERY CENTER OF PRESCOTT
Active
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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