Organization
TOOTH CASTLE PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA ANGELES FUENTES DDS (OWNER)
(602) 841-4400
Entity
Organization
Contact information
Practice address
10740 W LOWER BUCKEYE RD STE 105, AVONDALE, AZ 85323-9655
(602) 841-4400
Mailing address
PO BOX 32830, PHOENIX, AZ 85064-2830
(602) 841-4400
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D6064
AZ
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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