| Freedom Dental, Pllc | |
|
6328 E Brown Rd Ste 105 Mesa AZ 85205-4841 | |
| (480) 325-7639 | |
| (480) 654-8965 |
| Full Name | Freedom Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6328 E Brown Rd Ste 105, Mesa, Arizona |
| Authorized Official Name and Position | Richard Smith (OWNER/DENTIST) |
| Authorized Official Contact | 4803257639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Dental, Pllc 6328 E Brown Rd Ste 105 Mesa AZ 85205-4841 Ph: (480) 325-7639 | Freedom Dental, Pllc 6328 E Brown Rd Ste 105 Mesa AZ 85205-4841 Ph: (480) 325-7639 |
| NPI Number | 1396354205 |
|---|---|
| Provider Enumeration Date | 07/27/2020 |
| Last Update Date | 07/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396354205 | NPI | - | NPPES |
| 096649 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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