Healthcare Provider Details

I. General information

NPI: 1235294331
Provider Name (Legal Business Name): PHILIP ALLAN KUHNS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 WILLOW CREEK RD
PRESCOTT AZ
86301-1427
US

IV. Provider business mailing address

34 GLEN OAKS DR
PRESCOTT AZ
86305-5087
US

V. Phone/Fax

Practice location:
  • Phone: 928-778-6684
  • Fax:
Mailing address:
  • Phone: 928-445-0457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1953
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: