Individual
JEFFREY WITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 W WATKINS RD, PHOENIX, AZ 85003-2830
(602) 261-6842
Mailing address
1310 S 118TH DR, AVONDALE, AZ 85323-6286
(801) 989-7427
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D011453
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/02/2022
Last updated
05/16/2023
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