Organization
PUEBLO DEL SOL DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN M ISRAELSEN DMD (OWNER/MANAGER/DENTIST)
(520) 458-2415
Entity
Organization
Contact information
Practice address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635-4614
(520) 458-2415
(520) 458-0414
Mailing address
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635-4614
(520) 458-2415
(520) 458-0414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008200
AZ
Other
Enumeration date
07/31/2017
Last updated
07/21/2022
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