Individual
DR. ELLEN FAYE CAMPOMANES ALPANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042
(928) 737-6167
Mailing address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6162
(928) 737-6168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13745
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
955031
—
AZ
Enumeration date
03/05/2007
Last updated
07/08/2007
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