Organization
STARLIGHT ORTHODONTICS & PEDIATRIC DENTISTRY INC
Active
Organization
STARLIGHT ORTHODONTICS & PEDIATRIC DENTISTRY INC
Active
Other names
Starlight Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERT TAE (CEO)
(424) 392-2715
Entity
Organization
Contact information
Practice address
3440 W CACTUS RD STE 1, PHOENIX, AZ 85029-2238
(623) 688-3364
Mailing address
3440 W CACTUS RD STE 1, PHOENIX, AZ 85029-2238
(623) 688-3364
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
04/24/2023
Last updated
07/25/2023
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