Organization
RIO VISTA DENTAL ARTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J GENGLE DDS (MEMBER/DENTAL DIRECTOR)
(623) 878-6476
Entity
Organization
Contact information
Practice address
9145 W THUNDERBIRD RD, H-105, PEORIA, AZ 85381-4820
(623) 878-6476
Mailing address
9145 W THUNDERBIRD RD, H-105, PEORIA, AZ 85381-4820
(623) 878-6476
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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