Organization
STETSON VILLAGE DENTAL LLC
Active
Other names
Stetson Village Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKIN (CREDENTIALING DIRECTORY)
(972) 869-3789
Entity
Organization
Contact information
Practice address
3870 W HAPPY VALLEY RD STE 154, GLENDALE, AZ 85310-3296
(623) 533-4895
Mailing address
3870 W HAPPY VALLEY RD STE 154, GLENDALE, AZ 85310-3296
(623) 533-4895
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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