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General NPI Number Information
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NPI Number | 1043030968
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Entity Type | Organization
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Legal Business Name | SITTON, LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 9059 W LAKE PLEASANT PKWY STE 400
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City | PEORIA
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State | AZ
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Zip | 85382-8363
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Country | US
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Telephone | 208-591-0091
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Fax |
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Provider Business Mailing Address
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Address Line | 9059 W LAKE PLEASANT PKWY STE 400
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City | PEORIA
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State | AZ
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Zip | 85382-8363
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Country | US
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Telephone | 208-591-0091
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Fax |
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DANIEL PARKER SITTON
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Credential | DMD
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Telephone | 208-591-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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