Oral And Maxillofacial Surgeons Of Northern Arizona

NPI Provider: 1487651071
Contact Name: Peterson Dean Lorin
Position: President
Phone: (928) 773-2530

Oral And Maxillofacial Surgeons Of Northern Arizona Information:

Oral And Maxillofacial Surgeons Of Northern Arizona organization have npi 1487651071, taxonomy code is 1223P0106X with license number is 2803 in . This Business address located in 77 W Forest Ave, Flagstaff, AZ 86001 Arizona.

Practice Location
Address: 77 W Forest Ave, Flagstaff, AZ 86001
Phone: (928) 773-2530

Business Location
Address: 77 W Forest Ave, Flagstaff, AZ 86001
Phone: (928) 773-2530
Fax: (928) 773-2532

Taxonomy

Taxonomy Code: 1223P0106X

License Number: 2803

License Number of State: AZ

Primary Taxonomy Switch: Y

Enumeration Date: 6/28/2005

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