# MK TELEDENTISTRY

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

## Provider details

- **NPI number:** 1841981420
- **Authorized official:** MISTY THOMPSON (FOUNDER)
- **Authorized official phone:** (623) 999-5643

## Contact information

- **Practice address:** 3851 N 28TH ST APT 212, PHOENIX, AZ 85016-6832
- **Practice address phone:** (623) 999-5643
- **Mailing address:** 3851 N 28TH ST APT 212, PHOENIX, AZ 85016-6832
- **Mailing address phone:** (623) 999-5643

## Taxonomy

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

## Other

- **Enumeration date:** 05/16/2023
- **Last updated:** 07/17/2023