# RIO VISTA DENTAL ARTS PLLC

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

## Provider details

- **NPI number:** 1588897789
- **Authorized official:** DR. MICHAEL J GENGLE DDS (MEMBER/DENTAL DIRECTOR)
- **Authorized official phone:** (623) 878-6476

## Contact information

- **Practice address:** 9145 W THUNDERBIRD RD, H-105, PEORIA, AZ 85381-4820
- **Practice address phone:** (623) 878-6476
- **Mailing address:** 9145 W THUNDERBIRD RD, H-105, PEORIA, AZ 85381-4820
- **Mailing address phone:** (623) 878-6476

## Taxonomy

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

## Other

- **Enumeration date:** 09/03/2009
- **Last updated:** 09/03/2009