| Distinctive Dental Care | |
|
1000 Willow Creek Rd Suite H Prescott AZ 86301-1645 | |
| (928) 445-3181 | |
| (928) 445-5797 |
| Full Name | Distinctive Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1000 Willow Creek Rd, Prescott, Arizona |
| Authorized Official Name and Position | Paul Juan Wulff (OWNER) |
| Authorized Official Contact | 9284453181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Distinctive Dental Care 1000 Willow Creek Rd Suite H Prescott AZ 86301-1645 Ph: (928) 445-3181 | Distinctive Dental Care 1000 Willow Creek Rd Suite H Prescott AZ 86301-1645 Ph: (928) 445-3181 |
| NPI Number | 1043471493 |
|---|---|
| Provider Enumeration Date | 06/18/2008 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043471493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D3674 (Arizona) | Primary |
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