| |
1425 S Greenfield Rd Bldg 2 Ste 110 Mesa AZ 85206-5529 | |
(480) 854-3434 | |
(480) 854-2640 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1425 S Greenfield Rd, Mesa, Arizona |
Authorized Official Name and Position | Monica Vitela (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 6024827000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1425 S Greenfield Rd Bldg 2 Ste 110 Mesa AZ 85206-5529 Ph: (480) 854-3434 | 1425 S Greenfield Rd Bldg 2 Ste 110 Mesa AZ 85206-5529 Ph: (480) 854-3434 |
NPI Number | 1053631309 |
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Provider Enumeration Date | 06/09/2010 |
Last Update Date | 06/09/2010 |
Identifier | Type | State | Issuer |
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1053631309 | NPI | - | NPPES |
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