| State 48 Dental Pllc | |
|
5122 N 95th Ave Ste A100 Glendale AZ 85305-3044 | |
| (602) 312-1348 | |
| Not Available |
| Full Name | State 48 Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5122 N 95th Ave Ste A100, Glendale, Arizona |
| Authorized Official Name and Position | Brian Truong (PRINCIPAL) |
| Authorized Official Contact | 6023121348 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State 48 Dental Pllc 5122 N 95th Ave Ste A100 Glendale AZ 85305-3044 Ph: (602) 312-1348 | State 48 Dental Pllc 5122 N 95th Ave Ste A100 Glendale AZ 85305-3044 Ph: (602) 312-1348 |
| NPI Number | 1437732054 |
|---|---|
| Provider Enumeration Date | 05/02/2021 |
| Last Update Date | 05/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437732054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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