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Individual

DR. WADE ARTHUR MENDENHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10665 W INDIAN SCHOOL RD, SUITE J, AVONDALE, AZ 85323
(623) 772-5362
(623) 772-6036
Mailing address
10665 W INDIAN SCHOOL RD, SUITE J, AVONDALE, AZ 85323
(623) 772-5362
(623) 772-6036

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5259
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
538340
APIPA
AZ
01
53840
CDMP
01
666280
UNITED CONCORDIA
AZ
01
AZ0498470
BCBS OF AZ
AZ
Enumeration date
08/09/2006
Last updated
07/08/2007
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