# RIDGE DENTAL SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canyon Ridge Endodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689895765
- **Authorized official:** THOMAS PAUL LAMMOT DDS (PRESIDENT ENDODONTIST)
- **Authorized official phone:** (480) 538-8100

## Contact information

- **Practice address:** 20950 N TATUM BLVD, SUITE 210, PHOENIX, AZ 85050
- **Practice address phone:** (480) 538-8100
- **Practice address fax:** (480) 538-8101
- **Mailing address:** 20950 N TATUM BLVD, SUITE 210, PHOENIX, AZ 85050
- **Mailing address phone:** (480) 538-8100
- **Mailing address fax:** (480) 538-8101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | D6278 | AZ | — |
| 1223E0200X | Endodontics | D6338 | AZ | Yes |
| 1223E0200X | Endodontics | D6932 | AZ | — |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 08/22/2020