Organization
PLATINUM DENTAL SPA PLLC
Active
Other names
Modern Dentistry of SunCity
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA J BOTAR DDS (OWNER)
(623) 977-2551
Entity
Organization
Contact information
Practice address
13660 N 94TH DR STE B1, PEORIA, AZ 85381-4848
(623) 977-2551
Mailing address
13660 N 94TH DR STE B1, PEORIA, AZ 85381-4848
(623) 977-2551
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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