NPI 1043652910

Yuma Dental LLC

Organisation Preferred Provider Organization Yuma, AZ

Practice location

Address: 2540 S 4th Ave, Yuma, AZ 85364-7286
Phone: (928) 344-5700

Authorised official

Name: Justin Church
Title: Owner
Phone: (480) 206-0139

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 7892 (AZ)

Other Preferred Provider Organization providers in Arizona →

Registry record

NPI: 1043652910
Entity type: Organization
NPI issued: 22 Jul 2013
Record last updated: 22 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.