Organization
VAL VISTA DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIR MICHAEL ETEBARI D.D.S (MANAGING MEMBER)
(480) 558-0212
Entity
Organization
Contact information
Practice address
1395 E WARNER RD STE 105C, GILBERT, AZ 85296-3160
(480) 558-0212
(480) 558-0216
Mailing address
1395 E WARNER RD # 105C, GILBERT, AZ 85296-3160
(480) 558-0212
(480) 558-0216
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4900
AZ
Other
Enumeration date
05/16/2007
Last updated
08/22/2020
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