Individual
JASON DITTBERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
750 N KENDRICK ST STE 200, FLAGSTAFF, AZ 86001-1599
(928) 773-7900
Mailing address
750 N KENDRICK ST STE 200, FLAGSTAFF, AZ 86001-1599
(928) 773-7900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5045
AZ
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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