# MOON PAYNE MANAGEMENT LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AZ Dental Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063635985
- **Authorized official:** MRS. DEBBIE A GRAGG (PRACTICE MANAGER)
- **Authorized official phone:** (480) 222-8083

## Contact information

- **Practice address:** 3930 S ALMA SCHOOL RD, BLDG. B, STE. 6, CHANDLER, AZ 85248-4510
- **Practice address phone:** (480) 222-8083
- **Practice address fax:** (480) 222-8084
- **Mailing address:** 3930 S ALMA SCHOOL RD, BLDG. B, STE. 6, CHANDLER, AZ 85248-4510
- **Mailing address phone:** (480) 222-8083
- **Mailing address fax:** (480) 222-8084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D5136 | AZ | — |
| 1223G0001X | General Practice Dentistry | D5144 | AZ | Yes |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 08/22/2020