| East Valley Periodontics | |
|
6755 E Superstition Springs Blvd Ste. 102 Mesa AZ 85206-4373 | |
| (480) 218-7590 | |
| (480) 218-2247 |
| Full Name | East Valley Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 6755 E Superstition Springs Blvd, Mesa, Arizona |
| Authorized Official Name and Position | Penny Sue Mckinney (OFFICE MANAGER) |
| Authorized Official Contact | 4802187590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Valley Periodontics 6755 E Superstition Springs Blvd Ste. 102 Mesa AZ 85206-4373 Ph: (480) 218-7590 | East Valley Periodontics 6755 E Superstition Springs Blvd Ste. 102 Mesa AZ 85206-4373 Ph: (480) 218-7590 |
| NPI Number | 1063649192 |
|---|---|
| Provider Enumeration Date | 06/16/2009 |
| Last Update Date | 06/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063649192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 2619 (Arizona) | Primary |
| 1223P0300X | Dentist - Periodontics | 7751 (Arizona) | Secondary |
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