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2680 S Val Vista Dr Ste 125 Gilbert AZ 85295-2154 | |
| (480) 553-9909 | |
| (480) 553-9905 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2680 S Val Vista Dr Ste 125, Gilbert, Arizona |
| Authorized Official Name and Position | Mitchell R Lepetich (OWNER) |
| 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 | 1689005456 |
|---|---|
| Provider Enumeration Date | 12/04/2013 |
| Last Update Date | 12/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689005456 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7602 (Arizona) | Primary |
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