Organization
FREEDOM DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD SMITH DDS (OWNER/DENTIST)
(480) 325-7639
Entity
Organization
Contact information
Practice address
6328 E BROWN RD STE 105, MESA, AZ 85205-4841
(480) 325-7639
(480) 654-8965
Mailing address
6328 E BROWN RD STE 105, MESA, AZ 85205-4841
(480) 325-7639
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096649
—
AZ
Enumeration date
07/27/2020
Last updated
07/27/2020
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