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General NPI Number Information
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NPI Number | 1053688341
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Entity Type | Organization
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Legal Business Name | PACIFIC AVENUE DENTAL CARE
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 1630 S PACIFIC AVE STE 104
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City | YUMA
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State | AZ
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Zip | 85365-2111
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Country | US
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Telephone | 928-783-5609
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 S PACIFIC AVE STE 104
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City | YUMA
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State | AZ
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Zip | 85365-2111
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Country | US
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Telephone | 928-783-5609
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. FRANKLIN D HULME
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Credential | D.D.S.
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Telephone | 928-783-5609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AZ3056
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License Number State | AZ
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