Organization
SIMPLY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA BLATT (OFFICE MANAGER)
(623) 878-0882
Entity
Organization
Contact information
Practice address
10646 N 51ST AVE, GLENDALE, AZ 85304-4343
(623) 878-0882
(623) 979-3043
Mailing address
10646 N 51ST AVE, GLENDALE, AZ 85304-4343
(623) 878-0882
(623) 979-3043
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
D4955
AZ
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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