# PARKER DENTAL CENTER LLC

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093464711
- **Authorized official:** TERA NIEDENS (ACCOUNTANT)
- **Authorized official phone:** (623) 289-2616

## Contact information

- **Practice address:** 155 W RIVERSIDE DR, PARKER, AZ 85344-5221
- **Practice address phone:** (928) 669-0099
- **Mailing address:** 34225 N 27TH DR STE 241, PHOENIX, AZ 85085-6091
- **Mailing address phone:** (623) 289-2616

## Taxonomy

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

## Other

- **Enumeration date:** 03/21/2022
- **Last updated:** 03/21/2022