| Rustic Mountain Dentistry | |
|
606 N Main Street Taylor AZ 85939-8593 | |
| (928) 457-0758 | |
| (928) 457-0821 |
| Full Name | Rustic Mountain Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 606 N Main Street, Taylor, Arizona |
| Authorized Official Name and Position | Kenneth Houston Davis (DOCTOR/OWNER) |
| Authorized Official Contact | 9284570758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rustic Mountain Dentistry Po Box 1550 Taylor AZ 85939-1550 Ph: (928) 457-0758 | Rustic Mountain Dentistry 606 N Main Street Taylor AZ 85939-8593 Ph: (928) 457-0758 |
| NPI Number | 1063983245 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 12/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063983245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |