Desert Summit Dentistry, Pc | |
21681 N 77th Ave Ste 1420 Peoria AZ 85382-2133 | |
(623) 376-7233 | |
(623) 376-7234 |
Full Name | Desert Summit Dentistry, Pc |
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Speciality | Dentist |
Location | 21681 N 77th Ave Ste 1420, Peoria, Arizona |
Authorized Official Name and Position | Douglas Roy Gabriel (OWNER/DENTIST) |
Authorized Official Contact | 6233767233 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Desert Summit Dentistry, Pc 21681 N 77th Ave Ste 1420 Peoria AZ 85382-2133 Ph: (623) 376-7233 | Desert Summit Dentistry, Pc 21681 N 77th Ave Ste 1420 Peoria AZ 85382-2133 Ph: (623) 376-7233 |
NPI Number | 1831589910 |
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Provider Enumeration Date | 01/28/2015 |
Last Update Date | 01/28/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831589910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DO3749 (Arizona) | Primary |
122300000X | Dentist | DOO8946 (Arizona) | Secondary |
124Q00000X | Dental Hygienist | HO2603 (Arizona) | Secondary |
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