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 |
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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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