| Southwest Dental Professionals Pllc | |
|
316 W Angus Rd Queen Creek AZ 85143-4989 | |
| (480) 390-2060 | |
| Not Available |
| Full Name | Southwest Dental Professionals Pllc |
|---|---|
| Speciality | Dentist |
| Location | 316 W Angus Rd, Queen Creek, Arizona |
| Authorized Official Name and Position | Lawrence G Groop (OWNER/PRES) |
| Authorized Official Contact | 4806641449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Dental Professionals Pllc 316 W Angus Rd Queen Creek AZ 85143-4989 Ph: (480) 390-2060 | Southwest Dental Professionals Pllc 316 W Angus Rd Queen Creek AZ 85143-4989 Ph: (480) 390-2060 |
| NPI Number | 1154622249 |
|---|---|
| Provider Enumeration Date | 11/05/2010 |
| Last Update Date | 11/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154622249 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D07819 (Arizona) | Primary |
| 1223G0001X | Dentist - General Practice | D08719 (Arizona) | Secondary |
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