# MODEST DENTISTRY LLC

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

## Provider details

- **NPI number:** 1174215271
- **Authorized official:** PRATIK RANA MD (OWNER)
- **Authorized official phone:** (201) 706-1016

## Contact information

- **Practice address:** 4025 W BELL RD STE 19, PHOENIX, AZ 85053-2749
- **Practice address phone:** (602) 938-2736
- **Practice address fax:** (602) 938-3783
- **Mailing address:** 4025 W BELL RD STE 19, PHOENIX, AZ 85053-2749
- **Mailing address phone:** (602) 938-2736
- **Mailing address fax:** (602) 938-3783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/25/2023
- **Last updated:** 05/25/2023