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Individual

DR. KEVIN T AXX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4141 N 32ND ST STE 100, PHOENIX, AZ 85018-4775
(602) 667-3600
(602) 667-3611
Mailing address
1 E LEXINGTON AVE UNIT 1010, PHOENIX, AZ 85012-2494
(602) 667-3600
(602) 667-3611

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
050281
NY
1223E0200X
Endodontics
Primary
D7377
AZ
1223E0200X
Endodontics
DS036316
PA

Other

Enumeration date
09/13/2006
Last updated
08/24/2010
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