Organization
SV PEDIATRIC DENTISTRY, LLC
Active
Other names
Sun Valley Pediatric Dentistry Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E BALLARD (CFO, CIO)
(480) 889-9457
Entity
Organization
Contact information
Practice address
1220 S HIGLEY RD, SUITE #206, MESA, AZ 85206-4000
(480) 985-9110
(480) 924-5709
Mailing address
4435 E HOLMES AVE, MESA, AZ 85206-3372
(480) 889-9457
(480) 696-5505
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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