# CLOUD NINE DENTAL CARE, LLC

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

## Provider details

- **NPI number:** 1659981363
- **Authorized official:** ANNIE BALLARD (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (602) 518-0197

## Contact information

- **Practice address:** 111 W MONROE ST STE 131, PHOENIX, AZ 85003-1717
- **Practice address phone:** (602) 626-7952
- **Mailing address:** 2659 N RIDGE CIR, MESA, AZ 85203-2174
- **Mailing address phone:** (602) 518-0197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/06/2020
- **Last updated:** 08/06/2020