| Mona Lisa Dental | |
|
936 E Williams Field Rd Suite 101 Gilbert AZ 85296-4881 | |
| (480) 722-7600 | |
| (480) 722-0111 |
| Full Name | Mona Lisa Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 936 E Williams Field Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Carlos Alberto Vallecillo (PRESIDENT) |
| Authorized Official Contact | 4807227600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mona Lisa Dental 936 E Williams Field Rd Suite 101 Gilbert AZ 85296-4881 Ph: (480) 722-7600 | Mona Lisa Dental 936 E Williams Field Rd Suite 101 Gilbert AZ 85296-4881 Ph: (480) 722-7600 |
| NPI Number | 1023015914 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023015914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5778 (Arizona) | Primary |
| 1223G0001X | Dentist - General Practice | 5876 (Arizona) | Secondary |
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