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Organization
HIGHLAND AVENUE DENTAL PLLC
Active
Organization
HIGHLAND AVENUE DENTAL PLLC
Active
Other names
Highland Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
VICENTA REYES (LEAD OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
740 E HIGHLAND AVE STE 200, PHOENIX, AZ 85014-3679
(602) 264-0707
Mailing address
740 E HIGHLAND AVE STE 200, PHOENIX, AZ 85014-3679
(602) 264-0707
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/07/2022
Last updated
05/02/2023
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