San Tan Pediatric Dental | |
2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 | |
(480) 457-1693 | |
(480) 457-1321 |
Full Name | San Tan Pediatric Dental |
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Speciality | Dentist - Pediatric Dentistry |
Location | 2510 E Hunt Hwy, Queen Creek, Arizona |
Authorized Official Name and Position | Stephen J Montoya (OWNER) |
Authorized Official Contact | 4804571693 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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San Tan Pediatric Dental 2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 Ph: (480) 457-1693 | San Tan Pediatric Dental 2510 E Hunt Hwy Suite #29 Queen Creek AZ 85243-5206 Ph: (480) 457-1693 |
NPI Number | 1265625552 |
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Provider Enumeration Date | 08/21/2007 |
Last Update Date | 10/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265625552 | NPI | - | NPPES |
285009 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 7384 (Arizona) | Primary |
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