21152 Rittenhouse Llc | |
22717 S Ellsworth Rd Ste B102 Queen Creek AZ 85142-7575 | |
(480) 888-9596 | |
Not Available |
Full Name | 21152 Rittenhouse Llc |
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Speciality | Clinic/center - Dental |
Location | 22717 S Ellsworth Rd Ste B102, Queen Creek, Arizona |
Authorized Official Name and Position | Matthew Baker (MEMBER) |
Authorized Official Contact | 4802155133 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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21152 Rittenhouse Llc 22717 S Ellsworth Rd Ste B102 Queen Creek AZ 85142-7575 Ph: (480) 888-9596 | 21152 Rittenhouse Llc 22717 S Ellsworth Rd Ste B102 Queen Creek AZ 85142-7575 Ph: (480) 888-9596 |
NPI Number | 1609343680 |
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Provider Enumeration Date | 10/29/2018 |
Last Update Date | 10/29/2018 |
Identifier | Type | State | Issuer |
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1609343680 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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