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Organization
ARIZONA DENTAL PROFESSIONALS, P.C.
Active
Organization
ARIZONA DENTAL PROFESSIONALS, P.C.
Active
Parent organization
ARIZONA DENTAL PROFESSIONALS, P.C.
Other names
Village Grove Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARIZONA DENTAL PROFESSIONALS, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-8426
Entity
Organization
Contact information
Practice address
4120 N 197TH AVE, BUCKEYE, AZ 85396
(480) 696-8353
Mailing address
4120 N 197TH AVE, BUCKEYE, AZ 85396-8428
(623) 289-1873
(623) 289-1890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/23/2018
Last updated
10/03/2018
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