# ABC PEDIATRIC DENTAL PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1710304654
- **Authorized official:** DR. BENJAMIN MENLOVE DDS (PRESIDENT)
- **Authorized official phone:** (801) 448-2346

## Contact information

- **Practice address:** 16222 W BOCA RATON RD, SURPRISE, AZ 85379-5073
- **Practice address phone:** (801) 448-2346
- **Mailing address:** 4444 W THOMAS RD, PHOENIX, AZ 85031-3728
- **Mailing address phone:** (801) 448-2346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6361 | AZ | Yes |

## Other

- **Enumeration date:** 03/27/2014
- **Last updated:** 03/27/2014