Valley Orthodontic Group/ Peoria P.l.l.c. | |
25225 N Lake Pleasant Pkwy Ste 1240 Peoria AZ 85383-1390 | |
(623) 572-2683 | |
Not Available |
Full Name | Valley Orthodontic Group/ Peoria P.l.l.c. |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 25225 N Lake Pleasant Pkwy Ste 1240, Peoria, Arizona |
Authorized Official Name and Position | Daniel J Grob (OWNER/ORTHODONTIST) |
Authorized Official Contact | 4804907848 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Valley Orthodontic Group/ Peoria P.l.l.c. 25225 N Lake Pleasant Pkwy Ste 1240 Peoria AZ 85383-1390 Ph: (623) 572-2683 | Valley Orthodontic Group/ Peoria P.l.l.c. 25225 N Lake Pleasant Pkwy Ste 1240 Peoria AZ 85383-1390 Ph: (623) 572-2683 |
NPI Number | 1932608353 |
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Provider Enumeration Date | 02/12/2018 |
Last Update Date | 02/12/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932608353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DO3317 (Arizona) | Primary |
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