Organization
KINGMAN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGHANN SAMSON (MANAGER)
(928) 753-5069
Entity
Organization
Contact information
Practice address
1730 E BEVERLY AVE, KINGMAN, AZ 86409-3500
(928) 757-1707
(928) 757-3070
Mailing address
1730 E BEVERLY AVE, KINGMAN, AZ 86409-3500
(928) 757-1707
(928) 757-3070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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