# SUN LAKES FAMILY DENTAL LLC

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

## Provider details

- **NPI number:** 1700574605
- **Authorized official:** JEFFREY B FENN DMD (OWNER/DENTIST)
- **Authorized official phone:** (702) 325-7627

## Contact information

- **Practice address:** 10325 E RIGGS RD STE 109, SUN LAKES, AZ 85248-7647
- **Practice address phone:** (480) 883-8000
- **Mailing address:** 287 E HUNT HWY STE 101, SAN TAN VALLEY, AZ 85143-5096
- **Mailing address phone:** (702) 325-7627
- **Mailing address fax:** (833) 794-7366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/27/2023
- **Last updated:** 04/27/2023