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4854 E Baseline Rd Suite 101 Mesa AZ 85206-4636 | |
| (480) 654-1811 | |
| (480) 654-1040 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4854 E Baseline Rd, Mesa, Arizona |
| Authorized Official Name and Position | Sandra Garza Reyes (MANAGER OWNER DENTIST) |
| Authorized Official Contact | 4806541811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4854 E Baseline Rd Suite 101 Mesa AZ 85206-4636 Ph: (480) 654-1811 | 4854 E Baseline Rd Suite 101 Mesa AZ 85206-4636 Ph: (480) 654-1811 |
| NPI Number | 1033313564 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033313564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5716 (Arizona) | Primary |
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