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3875 E Williams Field Rd Ste 102 Gilbert AZ 85295-5062 | |
| (480) 685-9936 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3875 E Williams Field Rd Ste 102, Gilbert, Arizona |
| Authorized Official Name and Position | Paola Ramos (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3875 E Williams Field Rd Ste 102 Gilbert AZ 85295-5062 Ph: (480) 685-9936 | 3875 E Williams Field Rd Ste 102 Gilbert AZ 85295-5062 Ph: (480) 685-9936 |
| NPI Number | 1114601655 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 08/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114601655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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