| Core Family Dental | |
|
13460 N 94th Dr Ste K4 Peoria AZ 85381-4249 | |
| (232) 231-0366 | |
| Not Available |
| Full Name | Core Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13460 N 94th Dr Ste K4, Peoria, Arizona |
| Authorized Official Name and Position | Marvin Blane Jackson (OWNER) |
| Authorized Official Contact | 4356372100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Family Dental 13460 N 94th Dr Ste K4 Peoria AZ 85381-4249 Ph: (232) 231-0366 | Core Family Dental 13460 N 94th Dr Ste K4 Peoria AZ 85381-4249 Ph: (232) 231-0366 |
| NPI Number | 1689283814 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 07/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689283814 | NPI | - | NPPES |
| 586868 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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