# MESA DENTAL HEALTH

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

## Provider details

- **NPI number:** 1336965334
- **Authorized official:** KENT STAPLEY DMD (MANAGER MEMBER)
- **Authorized official phone:** (480) 830-8946

## Contact information

- **Practice address:** 1259 N POWER RD, MESA, AZ 85205-4909
- **Practice address phone:** (480) 830-8946
- **Practice address fax:** (480) 854-3869
- **Mailing address:** 1259 N POWER RD, MESA, AZ 85205-4909
- **Mailing address phone:** (480) 830-8946

## Taxonomy

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

## Other

- **Enumeration date:** 11/25/2024
- **Last updated:** 11/25/2024