Organization
ULTRA DENTAL PEORIA LLC
Active
Other names
Alpha Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBY YASSO DMD (GENERAL DENTIST)
(248) 705-8334
Entity
Organization
Contact information
Practice address
8345 W THUNDERBIRD RD STE B100, PEORIA, AZ 85381-3668
(602) 943-3700
Mailing address
8612 W MELINDA LN, PEORIA, AZ 85382-2499
(248) 705-8334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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