Organization
SAN TAN PEDIATRIC DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN J MONTOYA D.D.S. (OWNER)
(480) 457-1693
Entity
Organization
Contact information
Practice address
2510 E HUNT HWY, SUITE #29, QUEEN CREEK, AZ 85243-5206
(480) 457-1693
(480) 457-1321
Mailing address
2510 E HUNT HWY, SUITE #29, QUEEN CREEK, AZ 85243-5206
(480) 457-1693
(480) 457-1321
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7384
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285009
—
AZ
Enumeration date
08/21/2007
Last updated
10/09/2008
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