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20800 W Market St Ste 103 Buckeye AZ 85396-8040 | |
(623) 401-9440 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 20800 W Market St Ste 103, Buckeye, Arizona |
Authorized Official Name and Position | Jenny Garcia (CREDENTIALING LEAD) |
Authorized Official Contact | 9728693789 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 734753 Dallas TX 75373-4753 Ph: (623) 401-9440 | 20800 W Market St Ste 103 Buckeye AZ 85396-8040 Ph: (623) 401-9440 |
NPI Number | 1952020612 |
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Provider Enumeration Date | 08/25/2022 |
Last Update Date | 09/29/2022 |
Identifier | Type | State | Issuer |
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1952020612 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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