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2727 E Mckellips Rd Suite 101 Mesa AZ 85213-3106 | |
| (480) 612-6352 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2727 E Mckellips Rd, Mesa, Arizona |
| Authorized Official Name and Position | Kent James Spurling (STATUATORY AGENT) |
| Authorized Official Contact | 4802346669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2727 E Mckellips Rd Suite 101 Mesa AZ 85213-3106 Ph: (480) 612-6352 | 2727 E Mckellips Rd Suite 101 Mesa AZ 85213-3106 Ph: (480) 612-6352 |
| NPI Number | 1528514049 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 08/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528514049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D6969 (Arizona) | Primary |
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