Organization
PRESCOTT ENDODONTIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER D SMITH DDS (PRESIDENT)
(928) 771-1640
Entity
Organization
Contact information
Practice address
1658 OAKLAWN DRIVE, STE B, PRESCOTT, AZ 86305
(928) 771-1640
(928) 771-1673
Mailing address
1658 OAKLAWN DRIVE, STE B, PRESCOTT, AZ 86305
(928) 771-1640
(928) 771-1673
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D5788
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1516207
UNITED CONCORDIA
—
Enumeration date
04/21/2006
Last updated
08/22/2020
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