# VERDE DENTAL CARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1992037857
- **Authorized official:** DR. ERIC A PETTERSEN D.M.D. (MEMBER)
- **Authorized official phone:** (928) 567-5249

## Contact information

- **Practice address:** 522 W FINNIE FLATS RD, STE J, CAMP VERDE, AZ 86322-7265
- **Practice address phone:** (928) 567-5249
- **Mailing address:** PO BOX 788, CAMP VERDE, AZ 86322-0788
- **Mailing address phone:** (928) 567-5249
- **Mailing address fax:** (928) 567-0430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D3089 | AZ | Yes |

## Other

- **Enumeration date:** 02/03/2010
- **Last updated:** 02/03/2010