Individual
KRISTI WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10541 W AVENIDA DEL SOL, PEORIA, AZ 85383-9765
(406) 455-9405
Mailing address
10541 W AVENIDA DEL SOL, PEORIA, AZ 85383-9765
(406) 455-9405
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1309
MT
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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