Organization
GROWING GRINS PLLC
Active
Other names
Growing Grins Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIOR BERGER DMD (OWNER)
(480) 813-3636
Entity
Organization
Contact information
Practice address
3336 E CHANDLER HEIGHTS RD, SUITE 130, GILBERT, AZ 85297-4259
(480) 813-3636
Mailing address
413 E VAUGHN AVE, GILBERT, AZ 85234-6451
(480) 205-0222
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
AZ5756
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115115
AHCCCS
AZ
Enumeration date
10/16/2006
Last updated
08/22/2020
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