| Mountainside Family Dental | |
|
3961 E Chandler Blvd Ste 104 Phoenix AZ 85048-0303 | |
| (480) 759-4202 | |
| Not Available |
| Full Name | Mountainside Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 3961 E Chandler Blvd Ste 104, Phoenix, Arizona |
| Authorized Official Name and Position | Eric Lynn Kerbs (PRESIDENT) |
| Authorized Official Contact | 4807594202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountainside Family Dental 3961 E Chandler Blvd Ste 104 Phoenix AZ 85048-0303 Ph: (480) 759-4202 | Mountainside Family Dental 3961 E Chandler Blvd Ste 104 Phoenix AZ 85048-0303 Ph: (480) 759-4202 |
| NPI Number | 1164754032 |
|---|---|
| Provider Enumeration Date | 02/03/2010 |
| Last Update Date | 02/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164754032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6458 (Arizona) | Primary |
| 1223G0001X | Dentist - General Practice | 6458 (Arizona) | Secondary |
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