| Valley Pediatric Dentists P.c. | |
|
6239 E Brown Rd Suite #102 Mesa AZ 85205-4933 | |
| (480) 396-3660 | |
| (480) 396-3697 |
| Full Name | Valley Pediatric Dentists P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6239 E Brown Rd, Mesa, Arizona |
| Authorized Official Name and Position | Randall Keith Lout (PRESIDENT) |
| Authorized Official Contact | 4803963660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Pediatric Dentists P.c. 6239 E Brown Rd Suite #102 Mesa AZ 85205-4933 Ph: (480) 396-3660 | Valley Pediatric Dentists P.c. 6239 E Brown Rd Suite #102 Mesa AZ 85205-4933 Ph: (480) 396-3660 |
| NPI Number | 1295948883 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295948883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | D3911 (Arizona) | Primary |
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