# SANTAN DENTAL, PLLC

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

## Provider details

- **NPI number:** 1538308358
- **Authorized official:** MARY ELIZABETH TIERNEY RDH (OWNER)
- **Authorized official phone:** (520) 723-3801

## Contact information

- **Practice address:** 1185 N ARIZONA BLVD, COOLIDGE, AZ 85228-3203
- **Practice address phone:** (520) 723-3801
- **Mailing address:** PO BOX 1640, QUEEN CREEK, AZ 85242-1640
- **Mailing address phone:** (520) 723-3801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 124Q00000X | Dental Hygienist | — | NULL | Yes |
| 124Q00000X | Dental Hygienist | — | — | Yes |

## Other

- **Enumeration date:** 02/18/2009
- **Last updated:** 02/18/2009