Rustic Mountain Dentistry
Organization Active NPI Dental Clinic/Center · Taylor, AZ
NPI 1063983245 · NPPES record last updated Dec 16, 2018
Key facts
- NPI
- 1063983245
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- RUSTIC MOUNTAIN DENTISTRY
- Practice address
- 606 N Main Street
Taylor, AZ 85939-8593 - Phone
- (928) 457-0758
- Fax
- (928) 457-0821
- NPI assigned
- Dec 16, 2018
- Organization subpart
- No
Authorized official
- Name
- Kenneth Houston Davis, DMD
- Title
- Doctor/Owner
- Phone
- (928) 457-0758
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
606 N Main Street
Taylor, AZ 85939-8593
Mailing address
PO Box 1550
Taylor, AZ 85939-1550
Phone (928) 457-0758
Other providers in Taylor, AZ
- Northern Arizona Family Medicine, PC
- Oaksprings Counseling, LLC
- April Dawn Olmos
- Chloe Quast
- Renewal Mental Health
- Silvercreek Family Walkin Clinic, LLC
- Denise Renee Staker
- Zane A Stevens
- Jessica Stewart
- The Soar Clinic LLC
All providers in Taylor, AZ · Dental Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.