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Organization
DENTAL INNOVATIONS
Active
Organization
DENTAL INNOVATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA VAUGHN (MANAGER)
(623) 210-3416
Entity
Organization
Contact information
Practice address
160 S POWER RD, MESA, AZ 85206-5230
(480) 985-1910
Mailing address
34225 N 27TH DR BLDG 5 STE 241, PHOENIX, AZ 85085
(480) 985-1910
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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