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1942986419
DAKOTA WISE
FLAGSTAFF, AZ
NPI
1942986419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: AZ R80471)
Enumeration Date
2023-06-27
Last Update Date
2023-06-29
Business Address
DAKOTA WISE MD
2920 N 4TH ST
FLAGSTAFF, AZ 86004-1816
Phone number: 928-522-9400
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Mailing Address
DAKOTA WISE MD
PO BOX 3630
FLAGSTAFF, AZ 86003-3630
Phone number:
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