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545 E Hunt Hwy San Tan Valley AZ 85143 | |
| (480) 476-9180 | |
| (480) 476-9186 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 545 E Hunt Hwy, San Tan Valley, Arizona |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
545 E Hunt Hwy San Tan Valley AZ 85143 Ph: () - | 545 E Hunt Hwy San Tan Valley AZ 85143 Ph: (480) 476-9180 |
| NPI Number | 1942744081 |
|---|---|
| Provider Enumeration Date | 12/08/2016 |
| Last Update Date | 04/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942744081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Stan Kidtastic Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2510 E Hunt Hwy Ste 29, San Tan Valley, AZ 85143 Phone: 480-457-4693 | |