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MCKENZIE ROSE RAY

>> Dental Hygienist >> Dental Providers

Registrant NPI Number: 1124502620

Individual Registrant:
 MCKENZIE ROSE RAY 
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

Contact information for business:
PO BOX 617  SOMERTON, AZ 85350-0617 US
Tel: 928-236-8001  Fax: 928-722-6113

Registration Information:
NPI: 1124502620
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
AZH009160

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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