Organization
DENTAL SPECIALTY GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENNETT MANKIN (PRESIDENT)
(480) 239-2088
Entity
Organization
Contact information
Practice address
4435 E BROADWAY RD STE 7, MESA, AZ 85206-2012
(480) 471-8480
(480) 654-0705
Mailing address
3658 E MORRISON RANCH PKWY, GILBERT, AZ 85296-1816
(480) 239-2088
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
02/19/2021
Last updated
02/26/2021
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