Organization
RAE LAKES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON EDWARDS DMD (OWNER)
(480) 868-1864
Entity
Organization
Contact information
Practice address
3317 S HIGLEY RD, GILBERT, AZ 85297-5436
(480) 868-1864
Mailing address
1327 S NIELSON ST, GILBERT, AZ 85296-4265
(480) 868-1864
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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