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1601 W Apache Trl Ste 2 Apache Junction AZ 85120-3769 | |
| (480) 982-4200 | |
| (480) 982-4220 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1601 W Apache Trl Ste 2, Apache Junction, Arizona |
| Authorized Official Name and Position | Tracey Dalton (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 6236400267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1601 W Apache Trl Ste 2 Apache Junction AZ 85120-3769 Ph: (602) 354-5800 | 1601 W Apache Trl Ste 2 Apache Junction AZ 85120-3769 Ph: (480) 982-4200 |
| NPI Number | 1417099318 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417099318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D4013 (Arizona) | Primary |
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