Black Mountain Endodontics | |
21755 N 77th Ave Ste 1210 Peoria AZ 85382-2112 | |
(623) 248-0899 | |
(623) 248-9951 |
Full Name | Black Mountain Endodontics |
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Speciality | Dentist - Endodontics |
Location | 21755 N 77th Ave Ste 1210, Peoria, Arizona |
Authorized Official Name and Position | Cody Heslington (OWNER/ENDODONTIST) |
Authorized Official Contact | 8013185264 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Black Mountain Endodontics 21755 N 77th Ave Ste 1210 Peoria AZ 85382-2112 Ph: (623) 248-0899 | Black Mountain Endodontics 21755 N 77th Ave Ste 1210 Peoria AZ 85382-2112 Ph: (623) 248-0899 |
NPI Number | 1538829973 |
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Provider Enumeration Date | 12/27/2021 |
Last Update Date | 09/27/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538829973 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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