Organization
MOHAVE DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARK EARL MELSTROM DDS (OWNER)
(928) 757-3225
Entity
Organization
Contact information
Practice address
4601 STOCKTON HILL ROAD, KINGMAN, AZ 86409
(928) 757-3225
(928) 757-7477
Mailing address
4601 STOCKTON HILL ROAD, KINGMAN, AZ 86409
(928) 757-3225
(928) 757-7477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2714
AZ
Other
Enumeration date
04/21/2006
Last updated
02/02/2012
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