Most Relevant Information
Provider Data
| NPI Number: | 1003248899 |
| Provider Name: | KYLE MINTER PARKS D.M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 6043 |
Most Important Dates
| Enumeration Date: | 08/02/2013 |
| Last Updated: | 08/02/2013 |
Provider Practice Location
167 N MAIN ST.
TUBA CITY
AZ
86045
Practice Location Phone/Fax
| Phone: | 9282832672 |
| Fax: |
Provider Mailing Location
4015 E SOLIERE AVE
FLAGSTAFF
AZ
860047600
Provider Mailing Phone/Fax
| Phone: | 2563455841 |
| Fax: |