| Bradshaw Mountain Family Dental Group Pc | |
|
7136 Pav Way Prescott Valley AZ 86314-2264 | |
| (928) 775-9495 | |
| Not Available |
| Full Name | Bradshaw Mountain Family Dental Group Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7136 Pav Way, Prescott Valley, Arizona |
| Authorized Official Name and Position | David Frausto (PRESIDENT) |
| Authorized Official Contact | 9287759495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradshaw Mountain Family Dental Group Pc 7136 Pav Way Prescott Valley AZ 86314-2264 Ph: (928) 775-9495 | Bradshaw Mountain Family Dental Group Pc 7136 Pav Way Prescott Valley AZ 86314-2264 Ph: (928) 775-9495 |
| NPI Number | 1972773141 |
|---|---|
| Provider Enumeration Date | 03/04/2008 |
| Last Update Date | 03/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972773141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D5639 (Arizona) | Primary |
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