# PLAZA DENTAL

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

## Provider details

- **NPI number:** 1144509514
- **Authorized official:** MRS. AMY FRYE (OFFICE MANAGER)
- **Authorized official phone:** (623) 979-7477

## Contact information

- **Practice address:** 9145 W THUNDERBIRD RD STE 105, PEORIA, AZ 85381-4820
- **Practice address phone:** (623) 979-7477
- **Mailing address:** 9145 W THUNDERBIRD RD STE 105, PEORIA, AZ 85381-4820
- **Mailing address phone:** (623) 979-7477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3279 | CA | Yes |

## Other

- **Enumeration date:** 08/16/2011
- **Last updated:** 08/16/2011