| Dental Depot Orthodontics 83rd And Union Hills, Pllc | |
|
18855 N 83rd Ave Ste B Peoria AZ 85382-2806 | |
| (623) 352-0195 | |
| Not Available |
| Full Name | Dental Depot Orthodontics 83rd And Union Hills, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 18855 N 83rd Ave Ste B, Peoria, Arizona |
| Authorized Official Name and Position | Gaylon Zissa (DIRECTOR OF PROVIDER RELATIONS) |
| Authorized Official Contact | 4059458941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Depot Orthodontics 83rd And Union Hills, Pllc 2828 Nw 30th St Oklahoma City OK 73112-7404 Ph: (623) 267-4129 | Dental Depot Orthodontics 83rd And Union Hills, Pllc 18855 N 83rd Ave Ste B Peoria AZ 85382-2806 Ph: (623) 352-0195 |
| NPI Number | 1396586400 |
|---|---|
| Provider Enumeration Date | 06/03/2024 |
| Last Update Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396586400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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