# PDA HOLDINGS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Magic Smiles Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134345937
- **Authorized official:** AMANDA J TRUJILLO (CREDENTIALING MANAGER)
- **Authorized official phone:** (602) 253-6600

## Contact information

- **Practice address:** 1701 E THOMAS RD \#204, PHOENIX, AZ 85016
- **Practice address phone:** (602) 253-6600
- **Practice address fax:** (602) 279-0821
- **Mailing address:** 1701 E THOMAS RD STE 204, PHOENIX, AZ 85016-7675
- **Mailing address phone:** (602) 253-6600
- **Mailing address fax:** (602) 279-0821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 02/07/2023