# GRANT AND TANQUE VERDE DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grant and Tanque Verde Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821851551
- **Authorized official:** JEFFREY L ROBERTS DMD (DENTIST/PARTNER)
- **Authorized official phone:** (602) 790-4601

## Contact information

- **Practice address:** 6601 E GRANT RD STE 3, TUCSON, AZ 85715-3897
- **Practice address phone:** (602) 790-4601
- **Mailing address:** 6601 E GRANT RD STE 3, TUCSON, AZ 85715-3897
- **Mailing address phone:** (502) 790-4601

## Taxonomy

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

## Other

- **Enumeration date:** 02/05/2024
- **Last updated:** 02/05/2024