Organization
MODERN DENTAL PROFESSIONALS - ARIZONA PC
Active
Other names
BRIGHTNOW MESA COUNTRY CLUB DR
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY SMITH DDS (PRESIDENT)
(714) 428-2000
Entity
Organization
Contact information
Practice address
1855 S COUNTRY CLUB DR, STE 101, MESA, AZ 85210-6037
(714) 428-2000
Mailing address
1855 S COUNTRY CLUB DR, STE 101, MESA, AZ 85210-6037
(714) 428-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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