Provider Demographics
NPI:1659149730
Name:H. WAYNE CHESSER DDS PLLC
Entity Type:Organization
Organization Name:H. WAYNE CHESSER DDS PLLC
Other - Org Name:PRESCOTT DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CHESSER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-852-0055
Mailing Address - Street 1:7575 N OUTLOOK LN
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-4591
Mailing Address - Country:US
Mailing Address - Phone:970-852-0055
Mailing Address - Fax:
Practice Address - Street 1:222 S SUMMIT AVE STE 2
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-3780
Practice Address - Country:US
Practice Address - Phone:970-852-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental