| Az Lifetime Dentistry Llc | |
|
13065 W Mcdowell Rd Ste 112 Avondale AZ 85392-6439 | |
| (623) 455-6958 | |
| Not Available |
| Full Name | Az Lifetime Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13065 W Mcdowell Rd Ste 112, Avondale, Arizona |
| Authorized Official Name and Position | Gina Michelle Elrod (DENTIST/OWNER) |
| Authorized Official Contact | 4805442240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Lifetime Dentistry Llc 11445 E Via Linda Ste 2422 Scottsdale AZ 85259-2655 Ph: (480) 544-2240 | Az Lifetime Dentistry Llc 13065 W Mcdowell Rd Ste 112 Avondale AZ 85392-6439 Ph: (623) 455-6958 |
| NPI Number | 1841536612 |
|---|---|
| Provider Enumeration Date | 12/21/2012 |
| Last Update Date | 12/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841536612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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