# ARROWHEAD LAKES DENTISTRY P C

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

## Provider details

- **NPI number:** 1154537884
- **Authorized official:** DR. RONALD K SHELLEY DMD MAGD (OWNER DOCTOR)
- **Authorized official phone:** (623) 362-9616

## Contact information

- **Practice address:** 20265 N 59TH AVE, SUITE B 5, GLENDALE, AZ 85308
- **Practice address phone:** (623) 362-9616
- **Practice address fax:** (623) 362-2614
- **Mailing address:** 20265 N 59TH AVE, SUITE B 5, GLENDALE, AZ 85308
- **Mailing address phone:** (623) 362-9616
- **Mailing address fax:** (623) 362-2614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3505 | AZ | Yes |
| 1223G0001X | General Practice Dentistry | 4433 | AZ | — |
| 1223G0001X | General Practice Dentistry | 5928 | AZ | — |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 10/02/2012