| Arizona Periodontal Group Pllc | |
|
1717 W Northern Ave Ste 104 Phoenix AZ 85021-5469 | |
| (602) 995-5045 | |
| (602) 995-3222 |
| Full Name | Arizona Periodontal Group Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1717 W Northern Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Ariel Trujillo (OWNER) |
| Authorized Official Contact | 6029955045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Arizona Periodontal Group Pllc 1717 W Northern Ave Ste 104 Phoenix AZ 85021-5469 Ph: (602) 995-5045 | Arizona Periodontal Group Pllc 1717 W Northern Ave Ste 104 Phoenix AZ 85021-5469 Ph: (602) 995-5045 |
| NPI Number | 1134338973 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 02/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134338973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (Arizona) | Primary |
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