Page Dental Center

NPI #1164689139 in Page, Arizona

Provider Information

NPI Number: 1164689139
Entity Type: Organization
Organization Name: Page Dental Center
Primary Specialty: Dentist - General Practice
Enumeration Date: May 19, 2008
Last Updated: Dec 17, 2008

Practice Location

Address: 112 SIXTH AVENUE
City: Page
State: Arizona
ZIP Code: 86040-1956
Phone: (928) 645-3206

Authorized Official

Name: JEFFREY S GIFFORD, DMD
Title: PRESIDENT
Phone: (928) 645-3206

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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