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Organization

KIDS DENTAL GROUP PLLC

Active
Other names
Mesa Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL PONCE DDS (OWNER)
(646) 234-6578
Entity
Organization

Contact information

Practice address
6239 E BROWN RD STE 102, MESA, AZ 85205-4933
(480) 396-3660
Mailing address
6025 N 27TH AVE STE 25, PHOENIX, AZ 85017-1765
(602) 595-9199

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
04/24/2018
Last updated
04/24/2018
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