Individual
MELISSA JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13695 N 75TH AVE, PEORIA, AZ 85381-6098
(602) 439-1101
Mailing address
13695 N 75TH AVE, PEORIA, AZ 85381-6098
(505) 205-5421
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.025961
OH
122300000X
Dentist
Primary
D010372
AZ
Other
Enumeration date
08/26/2019
Last updated
11/09/2021
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