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Organization
NEW IMAGE DENTISTRY PLLC
Active
Organization
NEW IMAGE DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL GOMEZ (OWNER/GENERAL MANAGER)
(623) 825-9445
Entity
Organization
Contact information
Practice address
17235 N 75TH AVE STE A100, GLENDALE, AZ 85308-0884
(623) 825-9445
(623) 825-9446
Mailing address
17235 N 75TH AVE STE A100, GLENDALE, AZ 85308-0884
(623) 825-9445
(623) 825-9446
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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