Individual
DR. KENT H WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
512 E WHITEHOUSE CANYON RD, SUITE 120, GREEN VALLEY, AZ 85614-0550
(520) 625-6167
(520) 625-6169
Mailing address
512 E WHITEHOUSE CANYON RD, SUITE 120, GREEN VALLEY, AZ 85614-0550
(520) 625-6167
(520) 625-6169
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5837
AZ
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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