| Az Red Mountain Pediatric Dental Pllc | |
|
9101 E Brown Rd 102 Mesa AZ 85207-4350 | |
| (480) 565-8500 | |
| Not Available |
| Full Name | Az Red Mountain Pediatric Dental Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 9101 E Brown Rd, Mesa, Arizona |
| Authorized Official Name and Position | Jared W Welch (OWNER) |
| Authorized Official Contact | 4809179339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Az Red Mountain Pediatric Dental Pllc 9101 E Brown Rd 102 Mesa AZ 85207-4350 Ph: (480) 565-8500 | Az Red Mountain Pediatric Dental Pllc 9101 E Brown Rd 102 Mesa AZ 85207-4350 Ph: (480) 565-8500 |
| NPI Number | 1679027817 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 08/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679027817 | NPI | - | NPPES |
| 821497 | Medicaid | AZ | |
| 914227 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 5685 (Arizona) | Primary |
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