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NPI Profile for BONANZA SQUARE DENTISTRY LLC in PAYSON, AZ.
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
1223G0001X |
| NPI Number | 1104019918 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/24/2007 | |
| Last updated | 08/24/2007 - About 19 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BONANZA SQUARE DENTISTRY LLC