| Desert Lily Dental | |
|
12020 N 35th Ave Ste 2 Phoenix AZ 85029-3213 | |
| (435) 637-2100 | |
| Not Available |
| Full Name | Desert Lily Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12020 N 35th Ave Ste 2, Phoenix, Arizona |
| Authorized Official Name and Position | Tiffany Bray (MANAGER) |
| Authorized Official Contact | 4356372100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Lily Dental 12020 N 35th Ave Ste 2 Phoenix AZ 85029-3213 Ph: () - | Desert Lily Dental 12020 N 35th Ave Ste 2 Phoenix AZ 85029-3213 Ph: (435) 637-2100 |
| NPI Number | 1750974382 |
|---|---|
| Provider Enumeration Date | 02/15/2021 |
| Last Update Date | 02/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750974382 | NPI | - | NPPES |
| 586868 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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