# MOSAIC DENTISTRY PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1699928523
- **Authorized official:** DR. SAMUEL PETER DOMINICK III D.D.S. (PRESIDENT/MANAGER)
- **Authorized official phone:** (480) 821-8284

## Contact information

- **Practice address:** 290 W CHANDLER HEIGHTS RD, SUITE 3, CHANDLER, AZ 85248-5055
- **Practice address phone:** (480) 883-0222
- **Practice address fax:** (480) 883-0332
- **Mailing address:** 2933 S HOLGUIN WAY, CHANDLER, AZ 85286-3906
- **Mailing address phone:** (480) 821-8284
- **Mailing address fax:** (480) 821-8284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5248 | AZ | Yes |

## Other

- **Enumeration date:** 10/23/2008
- **Last updated:** 10/23/2008