Organization
THE DENTIST, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW T FRKETLICH (OWNER)
(602) 331-7001
Entity
Organization
Contact information
Practice address
9838 N 19TH AVE, SUITE K, PHOENIX, AZ 85021-1936
(602) 331-7007
(602) 331-7001
Mailing address
9838 N 19TH AVE, SUITE K, PHOENIX, AZ 85021-1936
(602) 331-7007
(602) 331-7001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0987
AZ
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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