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1220 S Higley Rd Suite #206 Mesa AZ 85206-4000 | |
| (480) 985-9110 | |
| (480) 924-5709 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1220 S Higley Rd, Mesa, Arizona |
| Authorized Official Name and Position | John E Ballard (CFO, CIO) |
| Authorized Official Contact | 4808899457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4435 E Holmes Ave Mesa AZ 85206-3372 Ph: (480) 889-9457 | 1220 S Higley Rd Suite #206 Mesa AZ 85206-4000 Ph: (480) 985-9110 |
| NPI Number | 1083086920 |
|---|---|
| Provider Enumeration Date | 10/29/2015 |
| Last Update Date | 10/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083086920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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