Organization
ESPERANZA DENTAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESPERANZA ALEJANDRA TORRES RDH (OWNER/SOLE MEMBER)
(602) 368-4050
Entity
Organization
Contact information
Practice address
321 W HATCHER RD STE 108, PHOENIX, AZ 85021-2400
(602) 368-4050
Mailing address
10636 N 39TH AVE, PHOENIX, AZ 85029-4057
(602) 465-0459
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
H6723
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12400000X
DENTAL HYGIENIST
AZ
Enumeration date
01/07/2015
Last updated
01/07/2015
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