# AERIS FAMILY DENTAL RITA RANCH

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

## Provider details

- **NPI number:** 1154627404
- **Authorized official:** LAN ALLEN DMD (MANAGER)
- **Authorized official phone:** (520) 777-6001

## Contact information

- **Practice address:** 10410 E RITA RANCH RD, TUCSON, AZ 85747-9035
- **Practice address phone:** (520) 777-6001
- **Mailing address:** 10410 E RITA RANCH RD, TUCSON, AZ 85747-9035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D6558 | AZ | Yes |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 02/03/2011
- **Last updated:** 01/23/2023