| Arizona Pediatric Dentistry And Orthodontic | |
|
4145 N 108th Ave Bldg K-101 Phoenix AZ 85037-5463 | |
| (623) 344-2000 | |
| (623) 344-2007 |
| Full Name | Arizona Pediatric Dentistry And Orthodontic |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4145 N 108th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Shashi M. Kapur (OWNER) |
| Authorized Official Contact | 6233442000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Pediatric Dentistry And Orthodontic 4145 N 108th Ave Bldg K-101 Phoenix AZ 85037-5463 Ph: (623) 344-2000 | Arizona Pediatric Dentistry And Orthodontic 4145 N 108th Ave Bldg K-101 Phoenix AZ 85037-5463 Ph: (623) 344-2000 |
| NPI Number | 1619021490 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619021490 | NPI | - | NPPES |
| F00359 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3801 (Arizona) | Primary |
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