# VALLECILLO & MENNA DENTISTRY, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Mona Lisa Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023015914
- **Authorized official:** DR. CARLOS ALBERTO VALLECILLO III DDS (PRESIDENT)
- **Authorized official phone:** (480) 722-7600

## Contact information

- **Practice address:** 936 E WILLIAMS FIELD RD, SUITE 101, GILBERT, AZ 85296-4881
- **Practice address phone:** (480) 722-7600
- **Practice address fax:** (480) 722-0111
- **Mailing address:** 936 E WILLIAMS FIELD RD, SUITE 101, GILBERT, AZ 85296-4881
- **Mailing address phone:** (480) 722-7600
- **Mailing address fax:** (480) 722-0111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5778 | AZ | Yes |
| 1223G0001X | General Practice Dentistry | 5876 | AZ | — |

## Other

- **Enumeration date:** 07/07/2005
- **Last updated:** 08/22/2020