Most Relevant Information
Provider Data
| NPI Number: | 1003486093 |
| Provider Name: | KAI PEDERSEN DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | D012042 |
Most Important Dates
| Enumeration Date: | 06/30/2021 |
| Last Updated: | 09/05/2024 |
Provider Practice Location
2240 WINROW RD
FORT HUACHUCA
AZ
856135080
Practice Location Phone/Fax
| Phone: | 5205339200 |
| Fax: | 5205335246 |
Provider Mailing Location
2240 WINROW RD
FORT HUACHUCA
AZ
856135080
Provider Mailing Phone/Fax
| Phone: | 5205339200 |
| Fax: | 5205335246 |