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Organization
OCOTILLO FAMILY DENTISTRY LLC
Active
Organization
OCOTILLO FAMILY DENTISTRY LLC
Active
Other names
Ocotillo Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
GIRIJA NADARAJAN (MANAGING MEMBER OWNER)
(480) 802-8686
Entity
Organization
Contact information
Practice address
995 E OCOTILLO RD, SUITE #3, CHANDLER, AZ 85249-3111
(480) 802-8686
(480) 802-8688
Mailing address
995 E OCOTILLO RD, SUITE #3, CHANDLER, AZ 85249-3111
(480) 802-8686
(480) 802-8688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1886702
UCCI
AZ
01
—
78195
DHA
AZ
Enumeration date
05/03/2007
Last updated
08/22/2020
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