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Organization
SUN WEST DENTAL IV, LLC
Active
Organization
SUN WEST DENTAL IV, LLC
Active
Other names
Sunwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY DALTON (DIRECTOR OF ADMINISTRATION)
(623) 680-3977
Entity
Organization
Contact information
Practice address
14557 W GRAND AVE STE B106, SURPRISE, AZ 85374-7104
(623) 374-3102
Mailing address
14557 W GRAND AVE STE B106, SURPRISE, AZ 85374-7104
(623) 374-3102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D4013
AZ
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/14/2007
Last updated
05/02/2023
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