# ELLIOT ROAD DENTAL - ISLAND PLLC

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

## Provider details

- **NPI number:** 1639846165
- **Authorized official:** FAITH GASKINS (CREDENTIALING DIRECTOR)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 1489 W ELLIOT RD STE 101, GILBERT, AZ 85233-5168
- **Practice address phone:** (480) 507-9400
- **Mailing address:** 1489 W ELLIOT RD STE 101, GILBERT, AZ 85233-5168
- **Mailing address phone:** (480) 507-9400

## Taxonomy

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

## Other

- **Enumeration date:** 08/24/2021
- **Last updated:** 08/24/2021