# DESIGNER DENTAL SERVICES PLLC

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

## Provider details

- **NPI number:** 1790451136
- **Authorized official:** TERA NIEDENS (ACCOUNTANT)
- **Authorized official phone:** (623) 289-2616

## Contact information

- **Practice address:** 20542 N LAKE PLEASANT RD STE 101, PEORIA, AZ 85382-9749
- **Practice address phone:** (623) 334-0012
- **Mailing address:** 34225 N 27TH DR STE 241, PHOENIX, AZ 85085-6091
- **Mailing address phone:** (623) 289-2616

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 08/17/2021