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2487 S Gilbert Rd Ste 105 Gilbert AZ 85295-2800 | |
| (480) 732-1888 | |
| (480) 732-1890 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2487 S Gilbert Rd Ste 105, Gilbert, Arizona |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 734753 Dallas TX 75373-4753 Ph: (480) 732-1888 | 2487 S Gilbert Rd Ste 105 Gilbert AZ 85295-2800 Ph: (480) 732-1888 |
| NPI Number | 1174165856 |
|---|---|
| Provider Enumeration Date | 10/14/2019 |
| Last Update Date | 09/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174165856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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