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Organization
THUNDERBIRD DENTAL STUDIO
Active
Organization
THUNDERBIRD DENTAL STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRNA MENDOZA (MANAGER)
(602) 906-9868
Entity
Organization
Contact information
Practice address
9179 W THUNDERBIRD RD STE 107, PEORIA, AZ 85381-4875
(623) 933-6010
Mailing address
9179 W THUNDERBIRD RD STE 107, PEORIA, AZ 85381-4875
(623) 933-6010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5722
AZ
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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