Organization
DENTISTS AT QUEEN CREEK, PLLC
Active
Other names
Lydian Dental QC
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY EDDY (CREDENTIALING MANAGER)
(713) 869-4535
Entity
Organization
Contact information
Practice address
21295 S ELLSWORTH LOOP RD, QUEEN CREEK, AZ 85142-9866
(480) 445-9188
(480) 526-8177
Mailing address
1046 WESTWOOD TRL, ONEIDA, NY 13421-4629
(315) 761-9837
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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