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2680 S Val Vista Dr Ste 125 Gilbert AZ 85295-2154 | |
| (480) 553-9909 | |
| (480) 553-9905 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2680 S Val Vista Dr Ste 125, Gilbert, Arizona |
| Authorized Official Name and Position | Tara Eagar (FRONT OFFICE MANAGER) |
| Authorized Official Contact | 4805539909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2680 S Val Vista Dr Ste 125 Gilbert AZ 85295-2154 Ph: (480) 553-9909 | 2680 S Val Vista Dr Ste 125 Gilbert AZ 85295-2154 Ph: (480) 553-9909 |
| NPI Number | 1033431085 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033431085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D7240 (Arizona) | Primary |
| 122300000X | Dentist | D7758 (Arizona) | Secondary |
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