Horizon Dental Group Spring Valley | |
17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 | |
(928) 632-9099 | |
(928) 458-7090 |
Full Name | Horizon Dental Group Spring Valley |
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Speciality | Dentist |
Location | 17301 E Spring Valley Rd Ste C, Spring Valley, Arizona |
Authorized Official Name and Position | Mark Anthony Costes (OWNER) |
Authorized Official Contact | 9289256522 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Horizon Dental Group Spring Valley 17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 Ph: (928) 632-9099 | Horizon Dental Group Spring Valley 17301 E Spring Valley Rd Ste C Spring Valley AZ 86333-4263 Ph: (928) 632-9099 |
NPI Number | 1063969046 |
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Provider Enumeration Date | 09/07/2016 |
Last Update Date | 09/07/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063969046 | NPI | - | NPPES |
731456 | Medicaid | AZ | |
703042 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | D5634 (Arizona) | Primary |