Organization
WESTERN DENTAL OF ARIZONA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOLEDAD NAVARRO (PPO COORDINATOR)
(714) 480-3000
Entity
Organization
Contact information
Practice address
1348 E FLORENCE BLVD, 7, CASA GRANDE, AZ 85122-5361
(520) 316-4287
(520) 316-4291
Mailing address
530 S MAIN ST, ORANGE, CA 92868-4525
(714) 480-3000
(714) 571-6445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G92150
—
AZ
Enumeration date
07/14/2014
Last updated
07/14/2014
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