Organization
VALLECILLO & MENNA DENTISTRY, P.C.
Active
Other names
Mona Lisa Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS ALBERTO VALLECILLO III DDS (PRESIDENT)
(480) 722-7600
Entity
Organization
Contact information
Practice address
936 E WILLIAMS FIELD RD, SUITE 101, GILBERT, AZ 85296-4881
(480) 722-7600
(480) 722-0111
Mailing address
936 E WILLIAMS FIELD RD, SUITE 101, GILBERT, AZ 85296-4881
(480) 722-7600
(480) 722-0111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5778
AZ
1223G0001X
General Practice Dentistry
5876
AZ
Other
Enumeration date
07/07/2005
Last updated
08/22/2020
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