Organization
THUNDERBIRD DENTAL MANAGEMENT LLC
Active
Other names
Plaza Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM WILDUNG (OWNER)
(480) 634-4803
Entity
Organization
Contact information
Practice address
9145 W THUNDERBIRD RD, SUITE H-105, PEORIA, AZ 85381-4820
(623) 979-7477
Mailing address
9145 W THUNDERBIRD RD, SUITE H-105, PEORIA, AZ 85381-4820
(623) 979-7477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009244
AZ
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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