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General NPI Number Information
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NPI Number | 1538783360
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Entity Type | Individual
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Provider Name | MADISON KURZ DMD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 5757 W THUNDERBIRD RD STE W300
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City | GLENDALE
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State | AZ
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Zip | 85306-5605
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Country | US
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Telephone | 602-439-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 N OLD STUMP WAY
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-7623
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Country | US
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Telephone | 520-907-8474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D010662
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License Number State | AZ
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