Provider Demographics
NPI:1861512444
Name:BRIMHALL, RODNEY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:BRIMHALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 WILLOW CREEK RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1645
Mailing Address - Country:US
Mailing Address - Phone:928-778-7181
Mailing Address - Fax:928-778-7195
Practice Address - Street 1:1000 WILLOW CREEK RD
Practice Address - Street 2:SUITE K
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1645
Practice Address - Country:US
Practice Address - Phone:928-778-7181
Practice Address - Fax:928-778-7195
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics