Organization
KRISTIAN C. DIETZ, DDS, PLLC
Active
Other names
Bright Ridge Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTIAN C DIETZ DDS (OWNER DENTIST)
(479) 715-4277
Entity
Organization
Contact information
Practice address
1603 SW REGIONAL AIRPORT BLVD., BENTONVILLE, AR 72712
(479) 715-4277
Mailing address
1603 SW REGIONAL AIRPORT BLVD., BENTONVILLE, AR 72712
(479) 715-4277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3913
AR
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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