# ARIZONA DENTAL PROFESSIONALS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ARIZONA DENTAL PROFESSIONALS, PC
- **Other names:** San Tan Mountain Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942744081
- **Legal business name:** ARIZONA DENTAL PROFESSIONALS, PC
- **Authorized official:** KENDRA WALKER (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (217) 540-8312

## Contact information

- **Practice address:** 545 E HUNT HWY, SAN TAN VALLEY, AZ 85143
- **Practice address phone:** (480) 476-9180
- **Practice address fax:** (480) 476-9186
- **Mailing address:** 545 E HUNT HWY, SAN TAN VALLEY, AZ 85143

## Taxonomy

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

## Other

- **Enumeration date:** 12/08/2016
- **Last updated:** 04/27/2017