| Blue Ridge Family Dentistry, Pc | |
|
1450 E White Mountain Blvd Ste A Pinetop AZ 85935-7091 | |
| (928) 367-4466 | |
| Not Available |
| Full Name | Blue Ridge Family Dentistry, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1450 E White Mountain Blvd Ste A, Pinetop, Arizona |
| Authorized Official Name and Position | Jonathan Hanridge (PRESIDENT, BRFD, PC) |
| Authorized Official Contact | 9283674466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Family Dentistry, Pc Po Box 3768 Pinetop AZ 85935-3768 Ph: (928) 367-4466 | Blue Ridge Family Dentistry, Pc 1450 E White Mountain Blvd Ste A Pinetop AZ 85935-7091 Ph: (928) 367-4466 |
| NPI Number | 1366914012 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366914012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Carl Peiser, D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1525 South Creel Ave, Pinetop, AZ 85935 Phone: 928-367-1682 Fax: 928-367-2702 |