Organization
DESERT VISTA DENTAL WEST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY K CORDOVA (OFFICE MANAGER)
(623) 935-2755
Entity
Organization
Contact information
Practice address
1646 N LITCHFIELD RD, SUITE 125, GOODYEAR, AZ 85395-1203
(623) 935-2755
(623) 935-0265
Mailing address
1646 N LITCHFIELD RD, SUITE 125, GOODYEAR, AZ 85395-1203
(623) 935-2755
(623) 935-0265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/31/2007
Last updated
10/15/2015
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