| Prescott Valley Dental Group | |
|
3264 Glassford Hill Road, Ste. A Prescott Valley AZ 86314 | |
| (928) 759-8000 | |
| Not Available |
| Full Name | Prescott Valley Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3264 Glassford Hill Road, Ste. A, Prescott Valley, Arizona |
| Authorized Official Name and Position | Darren L Line (OWNER) |
| Authorized Official Contact | 9287598000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prescott Valley Dental Group Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8890 | Prescott Valley Dental Group 3264 Glassford Hill Road, Ste. A Prescott Valley AZ 86314 Ph: (928) 759-8000 |
| NPI Number | 1932518404 |
|---|---|
| Provider Enumeration Date | 08/08/2014 |
| Last Update Date | 06/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932518404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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