# SONORAN VISTA DENTISTRY

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

## Provider details

- **NPI number:** 1598131146
- **Authorized official:** DR. JESSE HEAD DMD (DENTIST)
- **Authorized official phone:** (480) 586-4877

## Contact information

- **Practice address:** 1757 E BASELINE RD, \#129, GILBERT, AZ 85233-1532
- **Practice address phone:** (480) 545-0661
- **Mailing address:** 1757 E BASELINE RD, \#129, GILBERT, AZ 85233-1532
- **Mailing address phone:** (480) 545-0661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D008046 | AZ | Yes |

## Other

- **Enumeration date:** 08/18/2015
- **Last updated:** 08/18/2015