Organization
KENT H. WYATT, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT H. WYATT D.D.S. (PRESIDENT)
(520) 625-6167
Entity
Organization
Contact information
Practice address
512 E WHITEHOUSE CANYON RD, SUITE 120, GREEN VALLEY, AZ 85614-0500
(520) 625-6167
(520) 625-6169
Mailing address
512 E WHITEHOUSE CANYON RD, SUITE 120, GREEN VALLEY, AZ 85614-0500
(520) 625-6167
(520) 625-6169
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D5837
AZ
Other
Enumeration date
03/24/2006
Last updated
08/22/2020
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