| Mesa Pediatric Dentistry | |
|
6239 E Brown Rd Ste 102 Mesa AZ 85205-4933 | |
| (480) 396-3660 | |
| Not Available |
| Full Name | Mesa Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6239 E Brown Rd Ste 102, Mesa, Arizona |
| Authorized Official Name and Position | Daniel Ponce (OWNER) |
| Authorized Official Contact | 6462346578 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mesa Pediatric Dentistry 6025 N 27th Ave Ste 25 Phoenix AZ 85017-1765 Ph: (602) 595-9199 | Mesa Pediatric Dentistry 6239 E Brown Rd Ste 102 Mesa AZ 85205-4933 Ph: (480) 396-3660 |
| NPI Number | 1407344567 |
|---|---|
| Provider Enumeration Date | 04/24/2018 |
| Last Update Date | 04/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407344567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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