Organization
PARADISE VALLEY CENTER FOR COSMETIC AND COMPREHENSIVE DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITCH ELLINGSON DDS (PARTNER)
(602) 992-4510
Entity
Organization
Contact information
Practice address
11110 N TATUM BLVD, SUITE 102, PHOENIX, AZ 85028-1607
(602) 992-4510
Mailing address
11110 N TATUM BLVD, SUITE 102, PHOENIX, AZ 85028-1607
(602) 992-4510
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7229
AZ
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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