Organization
BISMARK LAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HUNT (OWNER)
(480) 280-4416
Entity
Organization
Contact information
Practice address
14175 W INDIAN SCHOOL RD STE B6, GOODYEAR, AZ 85395-8490
(602) 902-0275
Mailing address
1786 S 141ST PL, GILBERT, AZ 85295-4752
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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