Individual
DUSTIN ANTHONY DEDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3933 E CAMELBACK RD, PHOENIX, AZ 85018-2609
(602) 956-2494
Mailing address
19318 N 62ND DR, GLENDALE, AZ 85308-7660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S022750
AZ
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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