Organization
MESA MODERN DENTISTRY, LLP
Active
Other names
Mesa Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL C FAIRCHILD DDS (OWNER DOCTOR)
(480) 926-2350
Entity
Organization
Contact information
Practice address
3440 E BASELINE RD STE 106, MESA, AZ 85204-7247
(480) 926-2350
(480) 926-2366
Mailing address
2860 MICHELLE FL 2, IRVINE, CA 92606-1008
(714) 368-2077
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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