Individual
KEVIN CHITTENDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2010 E CEDAR AVE, FLAGSTAFF, AZ 86004-1621
(425) 870-3325
Mailing address
504 W FOX CHASE DR, DRAPER, UT 84020-4713
(425) 870-3325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
108466489922
UT
1223G0001X
General Practice Dentistry
Primary
D010629
AZ
Other
Enumeration date
06/13/2018
Last updated
05/06/2020
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