# INTRA DENTAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cornerstone Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609081652
- **Authorized official:** DR. ROY D SHIM DDS (PRESIDENT)
- **Authorized official phone:** (310) 227-0944

## Contact information

- **Practice address:** 6135 N 35TH AVE, SUITE 135, PHOENIX, AZ 85017-1950
- **Practice address phone:** (602) 973-0325
- **Practice address fax:** (602) 973-9704
- **Mailing address:** 6135 N 35TH AVE, SUITE 135, PHOENIX, AZ 85017-1950
- **Mailing address phone:** (602) 973-0325
- **Mailing address fax:** (602) 973-9704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D7163 | AZ | Yes |

## Other

- **Enumeration date:** 05/13/2007
- **Last updated:** 08/06/2007