# FLETCHER HEIGHTS DENTAL CARE PC

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

## Provider details

- **NPI number:** 1396772950
- **Authorized official:** DR. MICHAEL A PROST D.D.S. (DENTIST)
- **Authorized official phone:** (623) 825-7833

## Contact information

- **Practice address:** 8272 W. LAKE PLEASANT PKWY., \#204, PEORIA, AZ 85382-7432
- **Practice address phone:** (623) 825-7833
- **Practice address fax:** (623) 362-9141
- **Mailing address:** 8272 W. LAKE PLEASANT PKWY., \#204, PEORIA, AZ 85382-7432
- **Mailing address phone:** (623) 825-7833
- **Mailing address fax:** (623) 362-9141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010098A | IN | — |
| 1223G0001X | General Practice Dentistry | 4974 | AZ | Yes |

## Other

- **Enumeration date:** 06/27/2006
- **Last updated:** 08/22/2020