| Dr Wisdom Teeth | |
|
287 E Hunt Hwy Ste 101 San Tan Valley AZ 85143-5096 | |
| (833) 394-7366 | |
| Not Available |
| Full Name | Dr Wisdom Teeth |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 287 E Hunt Hwy Ste 101, San Tan Valley, Arizona |
| Authorized Official Name and Position | Jeffrey Fenn (OWNER) |
| Authorized Official Contact | 7023257627 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wisdom Teeth 287 E Hunt Hwy Ste 101 San Tan Valley AZ 85143-5096 Ph: (833) 394-7366 | Dr Wisdom Teeth 287 E Hunt Hwy Ste 101 San Tan Valley AZ 85143-5096 Ph: (833) 394-7366 |
| NPI Number | 1992298533 |
|---|---|
| Provider Enumeration Date | 06/08/2018 |
| Last Update Date | 06/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992298533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D009399 (Arizona) | Primary |
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