Healthcare Provider Details

I. General information

NPI: 1992920540
Provider Name (Legal Business Name): DAMON P. DON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6027 E GRANT RD
TUCSON AZ
85712-2316
US

IV. Provider business mailing address

6027 E GRANT RD
TUCSON AZ
85712-2316
US

V. Phone/Fax

Practice location:
  • Phone: 520-886-2309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3697
License Number StateAZ

VIII. Authorized Official

Name: DR. DAMON DON
Title or Position: PRES
Credential:
Phone: 520-886-2309