Spark Dentistry Pllc
NPI #1073234241 in Prescott Valley, Arizona
Provider Information
- NPI Number
- 1073234241
- Entity Type
- Organization
- Organization Name
- Spark Dentistry Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 7, 2022
- Last Updated
- Jun 20, 2023
Practice Location
- Address
- 7584 E STATE ROUTE 69
- City
- Prescott Valley
- State
- Arizona
- ZIP Code
- 86314-2278
- Phone
- (928) 499-3061
Authorized Official
- Name
- SIMON PARK
- Title
- OWNER
- Phone
- (928) 499-3061
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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