Healthcare Provider Details

I. General information

NPI: 1447255120
Provider Name (Legal Business Name): JOHN WILLIAM DAY DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N COUNTRY CLUB RD
TUCSON AZ
85716-4506
US

IV. Provider business mailing address

720 N COUNTRY CLUB RD
TUCSON AZ
85716-4506
US

V. Phone/Fax

Practice location:
  • Phone: 520-326-6658
  • Fax:
Mailing address:
  • Phone: 520-326-6658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2470
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: