Individual
DR. MILEN VITANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2701 E CAMELBACK RD STE 165, PHOENIX, AZ 85016
(602) 675-0896
Mailing address
2008 N 51ST WAY, PHOENIX, AZ 85008-4254
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.031422
IL
1223G0001X
General Practice Dentistry
Primary
D009557
AZ
Other
Enumeration date
02/12/2016
Last updated
10/31/2019
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