# PARADISE VALLEY ENDODONTIC GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689819062
- **Authorized official:** DR. JACQUELINE S ALLEN D.D.S.,M.S. (MEMBER)
- **Authorized official phone:** (480) 483-9001

## Contact information

- **Practice address:** 10585 N TATUM BLVD, D-132, PARADISE VALLEY, AZ 85253-1073
- **Practice address phone:** (480) 483-9001
- **Mailing address:** 10585 N TATUM BLVD, D-132, PARADISE VALLEY, AZ 85253-1073
- **Mailing address phone:** (480) 483-9001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 4952 | AZ | Yes |

## Other

- **Enumeration date:** 12/12/2008
- **Last updated:** 12/12/2008