| Desert Family Dental | |
|
1911 W Main St #6 Mesa AZ 85201-6929 | |
| (480) 838-4185 | |
| (480) 838-8746 |
| Full Name | Desert Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 1911 W Main St, Mesa, Arizona |
| Authorized Official Name and Position | Scott Ryan Lee (OWNER) |
| Authorized Official Contact | 4808384185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Family Dental 1911 W Main St #6 Mesa AZ 85201-6929 Ph: (480) 838-4185 | Desert Family Dental 1911 W Main St #6 Mesa AZ 85201-6929 Ph: (480) 838-4185 |
| NPI Number | 1295163418 |
|---|---|
| Provider Enumeration Date | 10/25/2013 |
| Last Update Date | 10/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295163418 | NPI | - | NPPES |
| 1427213172 | Other | AZ | DENTIST |
| 1003195413 | Other | AZ | DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7570 (Arizona) | Primary |
| 122300000X | Dentist | 8303 (Arizona) | Secondary |
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