# LEO J WIRTH DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Duane L Wirth DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902897580
- **Authorized official:** DR. DUANE L WIRTH DDS (DENTIST)
- **Authorized official phone:** (480) 964-3124

## Contact information

- **Practice address:** 1150 N COUNTRY CLUB DR, STE 11, MESA, AZ 85201-2537
- **Practice address phone:** (480) 964-3124
- **Practice address fax:** (480) 964-9252
- **Mailing address:** 1150 N COUNTRY CLUB DR, STE 11, MESA, AZ 85201-2537
- **Mailing address phone:** (480) 964-3124
- **Mailing address fax:** (480) 964-9252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2827 | AZ | — |
| 124Q00000X | Dental Hygienist | H0657 | AZ | Yes |
| 124Q00000X | Dental Hygienist | H0936 | AZ | — |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 09/11/2025