| Mountain Park Dentistry L.l.c. | |
|
15215 S 48th St Ste 175 Phoenix AZ 85044-9140 | |
| (480) 759-9300 | |
| (480) 759-2130 |
| Full Name | Mountain Park Dentistry L.l.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15215 S 48th St Ste 175, Phoenix, Arizona |
| Authorized Official Name and Position | Randy Mow (OWNER) |
| Authorized Official Contact | 4807599300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Park Dentistry L.l.c. 15215 S 48th St Ste 175 Phoenix AZ 85044-9140 Ph: (480) 759-9300 | Mountain Park Dentistry L.l.c. 15215 S 48th St Ste 175 Phoenix AZ 85044-9140 Ph: (480) 759-9300 |
| NPI Number | 1457719114 |
|---|---|
| Provider Enumeration Date | 02/09/2016 |
| Last Update Date | 02/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457719114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Secondary |
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