# QUEEN CREEK MODERN DENTISTRY, LLP

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

## Provider details

- **NPI number:** 1619725900
- **Authorized official:** APELDIN AGHASSI (DMD)
- **Authorized official phone:** (714) 845-8500

## Contact information

- **Practice address:** 25166 S ELLSWORTH RD STE B107, QUEEN CREEK, AZ 85142-0326
- **Practice address phone:** (602) 730-9795
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2024
- **Last updated:** 05/10/2024