| Plaza Family Dental Inc | |
|
9145 W Thunderbird Rd Ste H105 Peoria AZ 85381-4820 | |
| (623) 979-7477 | |
| Not Available |
| Full Name | Plaza Family Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 9145 W Thunderbird Rd Ste H105, Peoria, Arizona |
| Authorized Official Name and Position | Tim J Wildung (CEO) |
| Authorized Official Contact | 6023914107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Plaza Family Dental Inc 7205 E Southern Ave Ste A-122 Mesa AZ 85209-2790 Ph: (602) 391-4107 | Plaza Family Dental Inc 9145 W Thunderbird Rd Ste H105 Peoria AZ 85381-4820 Ph: (623) 979-7477 |
| NPI Number | 1669958781 |
|---|---|
| Provider Enumeration Date | 07/11/2018 |
| Last Update Date | 07/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669958781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D009244 (Arizona) | Primary |
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