Organization
ALTA SKY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED JUSTICE (MEMBER)
(858) 208-8451
Entity
Organization
Contact information
Practice address
4303 W PEORIA AVE, SUITE 104, GLENDALE, AZ 85302-2005
(623) 374-3714
Mailing address
4303 W PEORIA AVE, SUITE 104, GLENDALE, AZ 85302-2005
(623) 374-3714
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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