Individual
BLAIR AUSTIN WILLCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
19555 N 59TH AVE - CDMI, GLENDALE, AZ 85308
(480) 580-7222
Mailing address
2138 N ALAMO CIR, MESA, AZ 85213-2265
(480) 580-7222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AZD4391
AZ
Other
Enumeration date
10/11/2006
Last updated
11/04/2010
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