| Pediatric Dental Specialists, Ppc | |
|
2550 E Guadalupe Rd Suite 101 Gilbert AZ 85234-5114 | |
| (480) 558-0777 | |
| (480) 558-0888 |
| Full Name | Pediatric Dental Specialists, Ppc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2550 E Guadalupe Rd, Gilbert, Arizona |
| Authorized Official Name and Position | Jonathan Lee Staker (TREASURER) |
| Authorized Official Contact | 4805580777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Specialists, Ppc 2550 E Guadalupe Rd Suite 101 Gilbert AZ 85234-5114 Ph: (480) 558-0777 | Pediatric Dental Specialists, Ppc 2550 E Guadalupe Rd Suite 101 Gilbert AZ 85234-5114 Ph: (480) 558-0777 |
| NPI Number | 1336146745 |
|---|---|
| Provider Enumeration Date | 06/30/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336146745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Arizona) | Primary |
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