Organization
PRESCOTT VALLEY DENTAL GROUP, LLP
Active
Other names
PRESCOTT VALLEY DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREN L LINE DDS (OWNER)
(928) 759-8000
Entity
Organization
Contact information
Practice address
3264 GLASSFORD HILL ROAD, STE. A, PRESCOTT VALLEY, AZ 86314
(928) 759-8000
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/08/2014
Last updated
06/14/2022
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