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1905 E Mckellips Rd Mesa AZ 85203-2865 | |
| (480) 649-1949 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1905 E Mckellips Rd, Mesa, Arizona |
| Authorized Official Name and Position | Vinh Huynh (DENTIST/OWNER) |
| Authorized Official Contact | 4805263664 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1905 E Mckellips Rd Mesa AZ 85203-2865 Ph: (480) 526-3664 | 1905 E Mckellips Rd Mesa AZ 85203-2865 Ph: (480) 649-1949 |
| NPI Number | 1376009175 |
|---|---|
| Provider Enumeration Date | 02/16/2019 |
| Last Update Date | 02/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376009175 | NPI | - | NPPES |
| 1659659142 | Other | AZ | PPO AND HMO |
| 1376009175 | Medicaid | AZ | |
| 1659659142 | Medicaid | AZ | |
| 1376009175 | Other | AZ | PPO AND HMO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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