Organization
ARIZONA DENTAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG AVERY (OWNER)
(480) 835-1536
Entity
Organization
Contact information
Practice address
1629 E UNIVERSITY DR, MESA, AZ 85203-8139
(480) 835-1536
Mailing address
1629 E UNIVERSITY DR, MESA, AZ 85203-8139
(480) 835-1536
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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