Organization
GLENDALE GENTLE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRIS IGANIAN DDS (DENTIST/OWNER)
(623) 939-5131
Entity
Organization
Contact information
Practice address
8910 N 43RD AVE STE 104, GLENDALE, AZ 85302-5340
(623) 939-5131
Mailing address
8910 N 43RD AVE STE 104, GLENDALE, AZ 85302-5340
(623) 939-5131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6220
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
905987
—
AZ
Enumeration date
02/05/2015
Last updated
02/05/2015
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