# GLENDALE GENTLE DENTISTRY

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

## Provider details

- **NPI number:** 1063803518
- **Authorized official:** MR. KRIS IGANIAN DDS (DENTIST/OWNER)
- **Authorized official phone:** (623) 939-5131

## Contact information

- **Practice address:** 8910 N 43RD AVE STE 104, GLENDALE, AZ 85302-5340
- **Practice address phone:** (623) 939-5131
- **Mailing address:** 8910 N 43RD AVE STE 104, GLENDALE, AZ 85302-5340
- **Mailing address phone:** (623) 939-5131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6220 | AZ | Yes |

## Other

- **Enumeration date:** 02/05/2015
- **Last updated:** 02/05/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 905987 | — | AZ |