Individual
IVEY DANIELL AGEE WAINWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 836-3446
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6271
AL
1223G0001X
General Practice Dentistry
Primary
D009386
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2015
Last updated
08/10/2023
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