Organization
RICHARD MANGUM DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD TURNER MANGUM D.D.S. (PRESIDENT)
(928) 778-4110
Entity
Organization
Contact information
Practice address
1767 WILLOW CREEK RD, PRESCOTT, AZ 86301-1154
(928) 778-4110
(928) 778-4114
Mailing address
1767 WILLOW CREEK RD, PRESCOTT, AZ 86301-1154
(928) 778-4110
(928) 778-4114
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1904
AZ
Other
Enumeration date
11/25/2006
Last updated
08/22/2020
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