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MCKENZIE ROSE RAY
>> Dental Hygienist >> Dental ProvidersRegistrant NPI Number: 1124502620
Individual Registrant: MCKENZIE ROSE RAY
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
950 E MAIN ST BLDG B SOMERTON, AZ 85350-7409 US
Tel: 928-236-8001 Fax: 928-722-6113
Tel: 928-236-8001 Fax: 928-722-6113
Contact information for business:
PO BOX 617 SOMERTON, AZ 85350-0617 US
Tel: 928-236-8001 Fax: 928-722-6113
Tel: 928-236-8001 Fax: 928-722-6113
Registration Information:
NPI: 1124502620
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Providers Dental Hygienist | AZ | H009160 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
