| Sweet Tooth Pediatric Dentistry | |
|
5656 S. Power Rd. Ste. 118 Gilbert AZ 85295 | |
| (480) 988-1879 | |
| (480) 988-4690 |
| Full Name | Sweet Tooth Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5656 S. Power Rd., Gilbert, Arizona |
| Authorized Official Name and Position | Timothy J Bashara (OWNER, DENTIST) |
| Authorized Official Contact | 4809881879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sweet Tooth Pediatric Dentistry 5656 S. Power Rd. Ste. 118 Gilbert AZ 85295 Ph: (480) 988-1879 | Sweet Tooth Pediatric Dentistry 5656 S. Power Rd. Ste. 118 Gilbert AZ 85295 Ph: (480) 988-1879 |
| NPI Number | 1871707836 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871707836 | NPI | - | NPPES |
| 718794 | Medicaid | AZ | |
| 718794 | Other | AZ | AHCCCS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D5688 (Arizona) | Primary |
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