Lake Powell Dental Center, PC

NPI #1407392590 in Page, Arizona

Provider Information

NPI Number: 1407392590
Entity Type: Organization
Organization Name: Lake Powell Dental Center, PC
Primary Specialty: Dentist
Enumeration Date: Jan 12, 2017
Last Updated: Jan 12, 2017

Practice Location

Address: 436 VISTA AVENUE
Address 2: BOX 1956
City: Page
State: Arizona
ZIP Code: 86040
Phone: (928) 645-2505

Authorized Official

Name: JEFFREY S GIFFORD, DMD
Title: OWNER
Phone: (928) 645-2505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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