Organization
THUNDERBIRD DENTAL SMILES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
1820 W THUNDERBIRD RD STE 1, PHOENIX, AZ 85023-6300
(602) 993-6080
(602) 993-6061
Mailing address
1820 W THUNDERBIRD RD STE 1, PHOENIX, AZ 85023-6300
(602) 993-6080
(602) 993-6061
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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