# VAIL FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1750861233
- **Authorized official:** SEAN BALLEW (PRESIDENT)
- **Authorized official phone:** (520) 762-3236

## Contact information

- **Practice address:** 13190 E COLOSSAL CAVE RD STE 150, VAIL, AZ 85641-8822
- **Practice address phone:** (520) 762-3236
- **Practice address fax:** (520) 762-8058
- **Mailing address:** 13190 E COLOSSAL CAVE RD STE 150, VAIL, AZ 85641-8822
- **Mailing address phone:** (520) 762-3236
- **Mailing address fax:** (520) 762-8058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | D7579 | AZ | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/15/2018
- **Last updated:** 08/15/2018