| Phoenix Mountain Dentistry, Llc | |
|
4155 N 108th Ave Ste 101 Phoenix AZ 85037-5464 | |
| (623) 877-4044 | |
| (623) 877-0058 |
| Full Name | Phoenix Mountain Dentistry, Llc |
|---|---|
| Speciality | Dentist |
| Location | 4155 N 108th Ave Ste 101, Phoenix, Arizona |
| Authorized Official Name and Position | Fawne Pryor (AR AND INSURANCE MANAGER) |
| Authorized Official Contact | 6029440073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Mountain Dentistry, Llc 2323 W Mescal St Ste 205 Phoenix AZ 85029-4764 Ph: (602) 944-0073 | Phoenix Mountain Dentistry, Llc 4155 N 108th Ave Ste 101 Phoenix AZ 85037-5464 Ph: (623) 877-4044 |
| NPI Number | 1295850808 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295850808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5983 (Arizona) | Primary |
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