Organization
DESIRAE DENTAL SERVICES, PLLC
Active
Other names
Exceptional Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
STERLING DECKER (PRESIDENT)
(928) 814-6670
Entity
Organization
Contact information
Practice address
2872 JAMAICA BLVD S, LAKE HAVASU CITY, AZ 86406-7707
(928) 680-7645
(928) 680-9466
Mailing address
2872 JAMAICA BLVD S, LAKE HAVASU CITY, AZ 86406-7707
(928) 680-7645
(928) 680-9466
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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