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Organization

ARROWHEAD LAKES DENTISTRY P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD K SHELLEY DMD MAGD (OWNER DOCTOR)
(623) 362-9616
Entity
Organization

Contact information

Practice address
20265 N 59TH AVE, SUITE B 5, GLENDALE, AZ 85308
(623) 362-9616
(623) 362-2614
Mailing address
20265 N 59TH AVE, SUITE B 5, GLENDALE, AZ 85308
(623) 362-9616
(623) 362-2614

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3505
AZ
1223G0001X
General Practice Dentistry
4433
AZ
1223G0001X
General Practice Dentistry
5928
AZ

Other

Enumeration date
05/16/2007
Last updated
10/02/2012
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