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Organization
PRIMARY FAMILY DENTIST,LLC
Active
Organization
PRIMARY FAMILY DENTIST,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCOS GONDALES (OWNER)
(602) 249-3301
Entity
Organization
Contact information
Practice address
2902 W CAMELBACK RD, PHOENIX, AZ 85017-3301
(602) 249-3301
(602) 249-1117
Mailing address
2902 W CAMELBACK RD, PHOENIX, AZ 85017-3301
(602) 249-3301
(602) 249-1117
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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