# DENTAL HOME CONCEPTS

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

## Provider details

- **NPI number:** 1376214478
- **Authorized official:** MR. MICHELE M BANKS RDH (MANAGER)
- **Authorized official phone:** (480) 421-8928

## Contact information

- **Practice address:** 338 N 15TH AVE, PHOENIX, AZ 85007-2402
- **Practice address phone:** (480) 421-8928
- **Mailing address:** 36506 N 33RD AVE, PHOENIX, AZ 85086-0515
- **Mailing address phone:** (480) 421-8928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2021
- **Last updated:** 09/28/2021