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Organization

AZ LIFE DENTISTRY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAHAB ARDALAN DDS (MANAGING MEMBER)
(480) 861-5261
Entity
Organization

Contact information

Practice address
13065 W MCDOWELL RD, BUILDING B, SUITE #112, AVONDALE, AZ 85392-6439
(623) 455-3600
Mailing address
13065 W MCDOWELL RD, BUILDING B, SUITE #112, AVONDALE, AZ 85392-6439
(623) 455-3600

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
04/26/2011
Last updated
04/26/2011
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