# AZ LIFETIME DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841536612
- **Authorized official:** DR. GINA MICHELLE ELROD D.D.S. (DENTIST/OWNER)
- **Authorized official phone:** (480) 544-2240

## Contact information

- **Practice address:** 13065 W MCDOWELL RD STE 112, AVONDALE, AZ 85392-6439
- **Practice address phone:** (623) 455-6958
- **Mailing address:** 11445 E VIA LINDA STE 2422, SCOTTSDALE, AZ 85259-2655
- **Mailing address phone:** (480) 544-2240

## Taxonomy

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

## Other

- **Enumeration date:** 12/21/2012
- **Last updated:** 12/21/2012