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General NPI Number Information
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NPI Number | 1558899203
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Entity Type | Individual
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Provider Name | RAEGAN ADAIR ST. DENIS DMD
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Gender | Female
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1146 W STATE ROUTE 89A STE C1
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City | SEDONA
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State | AZ
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Zip | 86336-5770
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Country | US
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Telephone | 928-282-3266
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Fax |
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Provider Business Mailing Address
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Address Line | 928 W SALT MINE RD
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City | CAMP VERDE
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State | AZ
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Zip | 86322-7174
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Country | US
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Telephone | 859-519-8377
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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 | D011288
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License Number State | AZ
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