# CORE FAMILY DENTAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013530187
- **Authorized official:** ANTONIO QUINTANA (CEO)
- **Authorized official phone:** (480) 889-9457

## Contact information

- **Practice address:** 13460 N 94TH DR STE K4, PEORIA, AZ 85381-4249
- **Practice address phone:** (623) 223-1036
- **Mailing address:** 4435 E HOLMES AVE STE 200, MESA, AZ 85206-3314
- **Mailing address phone:** (480) 889-9457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2020
- **Last updated:** 05/24/2020