| Fiesta Kids Dental Llc | |
|
1303 S Longmore Suite #1 Mesa AZ 85202-9607 | |
| (480) 733-5437 | |
| (480) 733-4164 |
| Full Name | Fiesta Kids Dental Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1303 S Longmore, Mesa, Arizona |
| Authorized Official Name and Position | Stephen J Montoya (OWNER) |
| Authorized Official Contact | 4807335437 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fiesta Kids Dental Llc 1303 S Longmore Suite #1 Mesa AZ 85202-9607 Ph: (480) 733-5437 | Fiesta Kids Dental Llc 1303 S Longmore Suite #1 Mesa AZ 85202-9607 Ph: (480) 733-5437 |
| NPI Number | 1770840951 |
|---|---|
| Provider Enumeration Date | 04/12/2012 |
| Last Update Date | 04/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770840951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7384 (Arizona) | Primary |
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