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NPI Code Detail

MEDICARE: WESTWINDDENTAL DOWNTOWN

MEDICARE: WESTWINDDENTAL DOWNTOWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223D0001XPublic Health Dentistry

General Provider Information

NPI Number : 1275077513
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTWINDDENTAL DOWNTOWN
Provider Business Mailing Address
First Line : 3806 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2015
Country : US
Telephone Number : 602-277-1088
Fax Number :
Provider Business Practice Location Address
First Line : 3806 N 3RD ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2015
Country : US
Telephone Number : 602-277-1088
Fax Number :
Authorized Official
Title or Position : MANGER
Name : KRISTOPHER KNIGHT
Credential :
Telephone Number : 602-269-7797
Provider Enumeration Date : 12/06/2016
Last Update Date : 12/06/2016

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Directions to “WESTWINDDENTAL DOWNTOWN ” Practice Location

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