Individual
TRENTEN JAMES DIPPOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1300 N 12TH ST STE 500, PHOENIX, AZ 85006-2849
(602) 839-4567
Mailing address
555 N COLLEGE AVE APT 4047, TEMPE, AZ 85288-0222
(814) 706-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10657
AZ
Other
Enumeration date
08/17/2024
Last updated
01/08/2025
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