Organization
SOUTHWEST DENTAL PROFESSIONALS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE G GROOP DMD (OWNER/PRES)
(480) 664-1449
Entity
Organization
Contact information
Practice address
316 W ANGUS RD, QUEEN CREEK, AZ 85143-4989
(480) 390-2060
Mailing address
316 W ANGUS RD, QUEEN CREEK, AZ 85143-4989
(480) 390-2060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D07819
AZ
1223G0001X
General Practice Dentistry
D08719
AZ
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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