Organization
EAST VALLEY IMPLANT & PERIODONTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRETT E LEE (OFFICE MANAGER)
(480) 558-4504
Entity
Organization
Contact information
Practice address
3048 E BASELINE RD STE 112, MESA, AZ 85204-7287
(480) 558-4504
(480) 827-9703
Mailing address
3048 E BASELINE RD STE 112, MESA, AZ 85204-7287
(480) 558-4504
(480) 827-9703
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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