Individual
DR. JAMES WYATT LINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4550 E THOMAS RD, PHOENIX, AZ 85018-7610
(602) 551-8239
Mailing address
4550 E THOMAS RD, PHOENIX, AZ 85018-7610
(602) 551-8239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD4398
NM
1223G0001X
General Practice Dentistry
Primary
8803
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26551322
—
NM
Enumeration date
10/03/2013
Last updated
03/25/2022
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