Brandon John Tilts DDS

NPI 1073709366 - Dentist - 122300000X

NPI Details
NPI 1073709366
Gender Male
Enumeration Date 09/20/2007
Last Updated 03/26/2012
Entity Type Individual
Active Over 9 years ago
Practice Location
518 N BEAVER ST
SUITE A
FLAGSTAFF AZ, 86001-3020, US
Phone (928) 774-4705
Fax (928) 213-9665
Business Location
3505 W LEAD ROPE
FLAGSTAFF AZ, 86001-2302, US
Phone (928) 637-5354
Fax
Toxanomy
Taxonomy Code 122300000X
License State Arizona
License Number 7686
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According to our database, Brandon John Tilts DDS NPI is 1073709366, taxonomy code is 122300000X and license number is 7686, license state is located at Arizona. Brandon John Tilts DDS physically located at 518 N Beaver St, Flagstaff AZ, 86001-3020. NPI Number Brandon John Tilts DDS has the Individual type.

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1073709366 NPI number is provided on an as is basis without warranty of any kind. 1073709366 is maintained by the National Plan & Provider Enumeration System. The contents of Brandon John Tilts DDS are for informational purposes only.