Organization
SOUTH FRONTAGE ROAD DENTAL PLLC
Active
Other names
Gila Ridge Dental -Foothills
Organization subpart
No
Provider details
NPI number
Authorized official
VICENTA REYES (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
11259 S FRONTAGE RD STE 103, YUMA, AZ 85367-7883
(928) 342-7351
Mailing address
11259 S FRONTAGE RD STE 103, YUMA, AZ 85367-7883
(928) 342-7351
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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