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Organization

ULTRA DENTAL METRO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BOBBY YASSO DMD (OWNER/DENTIST)
(248) 705-8334
Entity
Organization

Contact information

Practice address
10621 N 35TH AVE, PHOENIX, AZ 85029-4260
(248) 705-8334
Mailing address
2938 E ROBIN LN, PHOENIX, AZ 85050-8420
(248) 705-8334

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
01/23/2026
Last updated
01/23/2026
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