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Organization
BASELINE ROAD DENTAL LLC
Active
Organization
BASELINE ROAD DENTAL LLC
Active
Other names
Desert Dental Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA ROCHA (SR TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
3130 E BASELINE RD 105/106, MESA, AZ 85204
(480) 701-6656
(480) 452-1614
Mailing address
3130 E BASELINE RD 105/106, MESA, AZ 85204
(480) 701-6656
(480) 452-1614
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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