# MAX DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Max Dental Club
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356211270
- **Authorized official:** DR. RYAN SCOTT WALLIN DDS (FOUNDER/CEO)
- **Authorized official phone:** (480) 218-8800

## Contact information

- **Practice address:** 22485 E. QUEEN CREEK RD. STE 105, QUEEN CREEK, AZ 85142
- **Practice address phone:** (480) 900-2331
- **Practice address fax:** (480) 218-7828
- **Mailing address:** 6626 E. BASELINE RD. STE 101, MESA, AZ 85206
- **Mailing address phone:** (480) 218-8800
- **Mailing address fax:** (480) 218-7828

## Taxonomy

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

## Other

- **Enumeration date:** 11/06/2025
- **Last updated:** 11/06/2025