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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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