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2080 E Williams Field Rd Suite #104 Gilbert AZ 85295-0702 | |
| (480) 759-1119 | |
| (480) 759-1180 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2080 E Williams Field Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Mary Madoche (PRACTICE MANAGER) |
| Authorized Official Contact | 4807591119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4232 E Chandler Blvd Suite #10 Phoenix AZ 85048-8879 Ph: (480) 759-1119 | 2080 E Williams Field Rd Suite #104 Gilbert AZ 85295-0702 Ph: (480) 759-1119 |
| NPI Number | 1184167447 |
|---|---|
| Provider Enumeration Date | 11/18/2016 |
| Last Update Date | 11/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184167447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 4457 (Arizona) | Primary |
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