Organization
KIDS DENTAL SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID HAASLO (MEMBER)
(480) 833-3330
Entity
Organization
Contact information
Practice address
1305 S ALMA SCHOOL RD, MESA, AZ 85210-2070
(480) 833-3330
(480) 461-0101
Mailing address
PO BOX 15387, PHOENIX, AZ 85060-5387
(480) 833-3330
(480) 461-0101
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D5802
AZ
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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