# DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA
- **Other names:** Mountainside Family Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811326226
- **Legal business name:** DYNAMIC DENTAL HEALTH ASSOCIATES OF ARIZONA
- **Authorized official:** ROSA LESSO (NATIONAL DIRECTOR OF RCM)
- **Authorized official phone:** (714) 571-3471

## Contact information

- **Practice address:** 3961 E CHANDLER BLVD, STE. 104, PHOENIX, AZ 85048-0303
- **Practice address phone:** (480) 759-4202
- **Practice address fax:** (480) 759-3514
- **Mailing address:** 136 4TH ST N STE 201, ST PETERSBURG, FL 33701-3889
- **Mailing address phone:** (727) 800-8026
- **Mailing address fax:** (727) 304-3164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2013
- **Last updated:** 04/04/2024