# PICASSO DENTAL AZ

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mark S. Anthony, DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326110024
- **Authorized official:** DR. MARK S ANTHONY DDS, P.C. (OWNER DENTIST)
- **Authorized official phone:** (480) 832-4567

## Contact information

- **Practice address:** 1259 N POWER RD, SUITE 2, MESA, AZ 85205-4909
- **Practice address phone:** (480) 832-4567
- **Practice address fax:** (480) 854-3869
- **Mailing address:** 1259 N POWER RD, SUITE 2, MESA, AZ 85205-4909
- **Mailing address phone:** (480) 832-4567
- **Mailing address fax:** (480) 854-3869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3908 | AZ | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 10/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 973102 | UNITED CONCORDIA | AZ |