Individual
DR. JUSTIN ISRAELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635-4614
(520) 458-2415
(520) 458-0414
Mailing address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635
(520) 458-2415
(520) 458-0414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8200
AZ
Other
Enumeration date
05/09/2012
Last updated
08/08/2017
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