Individual
DR. JONATHAN ICELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9000 N ORACLE RD, TUCSON, AZ 85704-7400
(520) 297-2007
Mailing address
1821 W ARROYO VISTA DR, TUCSON, AZ 85746-8152
(520) 344-2696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009525
AZ
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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