| Plaza Dental | |
|
9145 W Thunderbird Rd Suite H-105 Peoria AZ 85381-4820 | |
| (623) 979-7477 | |
| Not Available |
| Full Name | Plaza Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9145 W Thunderbird Rd, Peoria, Arizona |
| Authorized Official Name and Position | Tim Wildung (OWNER) |
| Authorized Official Contact | 4806344803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plaza Dental 9145 W Thunderbird Rd Suite H-105 Peoria AZ 85381-4820 Ph: (623) 979-7477 | Plaza Dental 9145 W Thunderbird Rd Suite H-105 Peoria AZ 85381-4820 Ph: (623) 979-7477 |
| NPI Number | 1275084501 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 10/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275084501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D009244 (Arizona) | Primary |
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