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Organization
MOBILE DENTISTRY OF AZ, LLC
Active
Organization
MOBILE DENTISTRY OF AZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN ROSS RDH (OWNER)
(480) 313-3310
Entity
Organization
Contact information
Practice address
2733 N POWER RD STE 102-449, MESA, AZ 85215-1758
(480) 313-3310
(480) 772-4032
Mailing address
2733 N POWER RD STE 102-449, MESA, AZ 85215-1758
(480) 313-3310
(480) 772-4032
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311Z00000X
Custodial Care Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
10/19/2012
Last updated
10/19/2012
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