Organization
MOUNTAIN PARK DENTISTRY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY MOW D.D.S. (OWNER)
(480) 759-9300
Entity
Organization
Contact information
Practice address
15215 S 48TH ST STE 175, PHOENIX, AZ 85044-9140
(480) 759-9300
(480) 759-2130
Mailing address
15215 S 48TH ST STE 175, PHOENIX, AZ 85044-9140
(480) 759-9300
(480) 759-2130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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