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Organization
TATUM POINT DENTISTRY LLC
Active
Organization
TATUM POINT DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA KELLICI (MANAGER)
(623) 439-2280
Entity
Organization
Contact information
Practice address
4747 E BELL RD, STE #15, PHOENIX, AZ 85032-2301
(623) 289-2580
Mailing address
TATUM POINT DENTISTRY LLC, 19601 N BLACK CANYON HWY, #201, PHOENIX, AZ 85027-4107
(623) 289-2580
(623) 289-2015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
09/15/2020
Last updated
08/30/2024
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