Individual
JESSICA DETTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2550 N THUNDERBIRD CIR, SUITE 303, MESA, AZ 85215-1215
(480) 289-7890
(866) 441-6493
Mailing address
2550 N THUNDERBIRD CIR, SUITE 303, MESA, AZ 85215-1215
(480) 289-7890
(866) 441-6493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4585
AZ
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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