| Sossaman Family Dental Pc | |
|
4704 E Southern Ave Suite # 118 Mesa AZ 85206-2737 | |
| (480) 648-4037 | |
| (480) 696-5505 |
| Full Name | Sossaman Family Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4704 E Southern Ave, Mesa, Arizona |
| Authorized Official Name and Position | Eric L Kerbs (PRESIDENT) |
| Authorized Official Contact | 4806484037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sossaman Family Dental Pc 4704 E Southern Ave Suite # 118 Mesa AZ 85206-2737 Ph: (480) 648-4037 | Sossaman Family Dental Pc 4704 E Southern Ave Suite # 118 Mesa AZ 85206-2737 Ph: (480) 648-4037 |
| NPI Number | 1952677254 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 12/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952677254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6458 (Arizona) | Secondary |
| 1223G0001X | Dentist - General Practice | 6458 (Arizona) | Primary |
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