KS AZ-1, PC

PHOENIX, AZ
NPI1588759161
Doing Business AsKOOL SMILES
Entity TypeOrganization
Authorized ContactDALE MAYFIELD
President
770-916-5028
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
Additional Taxonomies1223E0200X Dentist, Endodontics
1223S0112X Dentist, Oral and Maxillofacial Surgery
Enumeration Date2006-10-03
Last Update Date2014-12-17
Business Address
KS AZ-1, PC
3554 W GLENDALE AVE
PHOENIX, AZ 85051-8358
Phone number: 602-233-5665
Mailing Address
KS AZ-1, PC
1090 NORTHCHASE PKWY SE STE 150
MARIETTA, GA 30067-6407
Phone number: 770-916-5028