# EAST VALLEY DENTAL ASSOCIATES, LLC

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

## Provider details

- **NPI number:** 1063168367
- **Authorized official:** SHANNA ZUNIGA (MANAGER)
- **Authorized official phone:** (480) 497-1197

## Contact information

- **Practice address:** 1851 E BASELINE RD STE 103, GILBERT, AZ 85233-1536
- **Practice address phone:** (480) 497-1179
- **Practice address fax:** (480) 539-5657
- **Mailing address:** 1851 E BASELINE RD STE 103, GILBERT, AZ 85233-1536
- **Mailing address phone:** (480) 497-1179
- **Mailing address fax:** (480) 539-5657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/24/2022
- **Last updated:** 02/24/2022