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General NPI Number Information
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NPI Number | 1619132487
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Entity Type | Individual
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Provider Name | CODY HARRIS SKINNER DMD
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Gender | Male
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 1325 W 16TH ST STE A
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City | YUMA
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State | AZ
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Zip | 85364-4496
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Country | US
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Telephone | 928-782-3839
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Fax | 928-782-3839
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Provider Business Mailing Address
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Address Line | 1325 W 16TH ST STE A
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City | YUMA
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State | AZ
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Zip | 85364-4496
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Country | US
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Telephone | 928-782-3839
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Fax | 928-329-9029
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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 | D7604
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License Number State | AZ
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