NPI 1831554930

Dental Specialists of NW Arizona

Organisation Periodontics Lake Havasu City, AZ

Practice location

Address: 2152 McCulloch Blvd N STE C, Lake Havasu City, AZ 86403-6805
Phone: (928) 854-5551

Authorised official

Name: Ryan Lavene
Title: Endodontist
Phone: (928) 854-5551

Registered specialties (2)

Periodontics Primary

Dental Providers Taxonomy 1223P0300X Licence 8823 (AZ)

Other Dentist providers in Arizona →

Endodontics

Dental Providers Taxonomy 1223E0200X Licence 8793 (AZ)

Registry record

NPI: 1831554930
Entity type: Organization
NPI issued: 16 Dec 2015
Record last updated: 16 Dec 2015

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.