| Magnolia Dental Llc | |
|
2346 E Brown Rd Mesa AZ 85213-5255 | |
| (435) 637-2100 | |
| Not Available |
| Full Name | Magnolia Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2346 E Brown Rd, Mesa, Arizona |
| Authorized Official Name and Position | Marvin Blane Jackson (OWNER) |
| Authorized Official Contact | 4356372100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Dental Llc 250 N Fairgrounds Rd Ste 1 Price UT 84501-4201 Ph: (435) 637-2100 | Magnolia Dental Llc 2346 E Brown Rd Mesa AZ 85213-5255 Ph: (435) 637-2100 |
| NPI Number | 1508684267 |
|---|---|
| Provider Enumeration Date | 10/01/2024 |
| Last Update Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508684267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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