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10147 Grand Ave Ste A-5 Sun City AZ 85351-3435 | |
| (623) 977-4001 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10147 Grand Ave Ste A-5, Sun City, Arizona |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2403 Lacy Ln Carrollton TX 75006-6514 Ph: (972) 869-3789 | 10147 Grand Ave Ste A-5 Sun City AZ 85351-3435 Ph: (623) 977-4001 |
| NPI Number | 1568024834 |
|---|---|
| Provider Enumeration Date | 07/08/2019 |
| Last Update Date | 07/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568024834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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