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Organization
PDA HOLDCO CHANDLER LLC
Active
Organization
PDA HOLDCO CHANDLER LLC
Active
Other names
Kids Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
JERAMY TARWATER (PRESIDENT)
(602) 253-6600
Entity
Organization
Contact information
Practice address
2900 W RAY RD STE 2, CHANDLER, AZ 85224-7342
(480) 782-5437
(480) 857-7888
Mailing address
2900 W RAY RD STE 2, CHANDLER, AZ 85224-7342
(480) 782-5437
(480) 857-7888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8502
AZ
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/27/2016
Last updated
02/07/2023
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