Prescott Periodontics & Implant Dentistry, Pllc

NPI #1891244281 in Prescott, Arizona

Provider Information

NPI Number: 1891244281
Entity Type: Organization
Organization Name: Prescott Periodontics & Implant Dentistry, Pllc
Primary Specialty: Dentist - Periodontics
Enumeration Date: Sep 26, 2016
Last Updated: Sep 26, 2016

Practice Location

Address: 1229 WILLOW CREEK RD
City: Prescott
State: Arizona
ZIP Code: 86301-1427
Phone: (928) 778-2340

Authorized Official

Name: DR. RICHARD CHARLES JIRSA, D.D.S, M.S.
Title: PERIODONTIST
Phone: (928) 778-2340

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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