MEDICARE: DR. DEBORAH ANN KINZER D.D.S.

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
1	1223G0001X	General Practice Dentistry	3920	AZ

General Provider Information

NPI Number	:	1528106093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH ANN KINZER D.D.S.

Provider Business Mailing Address
First Line	:	2167 BIRCH SQ
Second Line	:	SUITE #D
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-6671
Country	:	US
Telephone Number	:	928-453-2228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2167 BIRCH SQ
Second Line	:	SUITE #D
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-6671
Country	:	US
Telephone Number	:	928-453-2228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2007
Last Update Date	:	07/08/2007

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