| Southern Dental | |
|
3320 W Southern Ave #111 Phoenix AZ 85041 | |
| (602) 305-8800 | |
| Not Available |
| Full Name | Southern Dental |
|---|---|
| Speciality | Dentist |
| Location | 3320 W Southern Ave #111, Phoenix, Arizona |
| Authorized Official Name and Position | Mark Wilkes Morris (SOLE OWNER/GENERAL DENTIST) |
| Authorized Official Contact | 3123390588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Dental 1 East Washington St Ste 500 Phoenix AZ 85004 Ph: (480) 696-1095 | Southern Dental 3320 W Southern Ave #111 Phoenix AZ 85041 Ph: (602) 305-8800 |
| NPI Number | 1447780135 |
|---|---|
| Provider Enumeration Date | 06/14/2017 |
| Last Update Date | 06/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447780135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9690 (Arizona) | Primary |
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