Organization
CEDAR DENTAL GROUP, PC
Active
Other names
M & C Community Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE R AYOUB DDS (DENTIST)
(602) 307-5775
Entity
Organization
Contact information
Practice address
333 E VIRGINIA AVE, SUITE 115, PHOENIX, AZ 85004-1206
(602) 307-5775
(602) 307-9041
Mailing address
333 E VIRGINIA AVE, SUITE 115, PHOENIX, AZ 85004-1206
(602) 307-5775
(602) 307-9041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6399
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
951500
AHCCCS PROVIDER NUMBER
AZ
Enumeration date
03/03/2010
Last updated
03/03/2010
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