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Organization
VAIL FAMILY DENTISTRY
Active
Organization
VAIL FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN BALLEW (PRESIDENT)
(520) 762-3236
Entity
Organization
Contact information
Practice address
13190 E COLOSSAL CAVE RD STE 150, VAIL, AZ 85641-8822
(520) 762-3236
(520) 762-8058
Mailing address
13190 E COLOSSAL CAVE RD STE 150, VAIL, AZ 85641-8822
(520) 762-3236
(520) 762-8058
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D7579
AZ
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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