Organization
LAVEEN MODERN DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA GIRARDI D.M.D. (DENTIST)
(209) 481-2544
Entity
Organization
Contact information
Practice address
5045 W BASELINE RD STE 135, LAVEEN, AZ 85339-7394
(602) 237-0613
Mailing address
3036 W MOHAWK LN, PHOENIX, AZ 85027-3117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9657
AZ
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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