Individual
KEITH ESKANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3103 CLEARWATER DR, SUITE B, PRESCOTT, AZ 86305-7165
(928) 237-6456
(928) 777-3209
Mailing address
3103 CLEARWATER DR, SUITE B, PRESCOTT, AZ 86305-7165
(928) 237-6456
(928) 777-3209
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6419
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920315
—
AZ
01
—
AZ0415100
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
06/24/2006
Last updated
09/27/2012
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