| Southern Arizona Periodontics Plc | |
|
5225 E Knight Dr Ste #401 Tucson AZ 85712 | |
| (520) 322-9300 | |
| (520) 322-6889 |
| Full Name | Southern Arizona Periodontics Plc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 5225 E Knight Dr, Tucson, Arizona |
| Authorized Official Name and Position | Jacqueline Greenwall (OFFICE MANAGER) |
| Authorized Official Contact | 5203229300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Arizona Periodontics Plc 5225 E Knight Dr Ste #401 Tucson AZ 85712 Ph: (520) 322-9300 | Southern Arizona Periodontics Plc 5225 E Knight Dr Ste #401 Tucson AZ 85712 Ph: (520) 322-9300 |
| NPI Number | 1417055294 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417055294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 4087 (Arizona) | Primary |
| 1223P0300X | Dentist - Periodontics | 2591 (Arizona) | Secondary |
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