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General NPI Number Information
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NPI Number | 1720298383
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Entity Type | Organization
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Legal Business Name | SIX CROWNS, INC.
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1998 ELECTRIC DR. A
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City | GLOBE
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State | AZ
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Zip | 85501
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Country | US
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Telephone | 928-425-3162
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1243
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City | GLOBE
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State | AZ
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Zip | 85502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES P. SMITH
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Credential | D.M.D.
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Telephone | 928-425-3162
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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 | 3349
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License Number State | AZ
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