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Organization
DESERT RIDGE PEDIATRIC DENTISTRY
Active
Organization
DESERT RIDGE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIDIETH R LIBBY D.D.S. (OWNER)
(480) 585-5868
Entity
Organization
Contact information
Practice address
5315 E. HIGH STREET, SUITE 115, PHOENIX, AZ 85054
(480) 585-5868
(480) 585-1208
Mailing address
5315 E HIGH ST, SUITE 115, PHOENIX, AZ 85054-5438
(480) 585-5868
(480) 585-1208
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5548
AZ
Other
Enumeration date
10/26/2007
Last updated
07/17/2015
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