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Organization
PARADISE RIDGE FAMILY DENTISTRY LLC
Active
Organization
PARADISE RIDGE FAMILY DENTISTRY LLC
Active
Other names
Paradise Ridge Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY CLARK TILLEY (OWNER/GM)
(602) 695-4192
Entity
Organization
Contact information
Practice address
15433 N TATUM BLVD STE 200, PHOENIX, AZ 85032-4228
(602) 755-4691
Mailing address
16627 S LINDSAY RD, GILBERT, AZ 85295-1501
(602) 695-4192
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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