Organization
MOUNTAINSIDE DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARON CLARE (GENERAL MANAGER)
(480) 981-0590
Entity
Organization
Contact information
Practice address
6549 E UNIVERSITY DR, SUITE B, MESA, AZ 85205-7600
(480) 981-0590
Mailing address
6549 E UNIVERSITY DR, SUITE B, MESA, AZ 85205-7600
(480) 981-0590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
L16075880
AZ
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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