Organization
A & N SUNVALLEY DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANDANA KHESHTCHIN D.D.S. (DENTIST)
(480) 921-3811
Entity
Organization
Contact information
Practice address
960 W UNIVERSITY DR, STE. #115, TEMPE, AZ 85281-7808
(480) 921-3811
(480) 921-3830
Mailing address
960 W UNIVERSITY DR, STE. #115, TEMPE, AZ 85281-7808
(480) 921-3811
(480) 921-3830
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
D5191
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
521858002
—
AZ
Enumeration date
12/30/2008
Last updated
12/30/2008
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