Organization
SONORAN VISTA DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE HEAD DMD (DENTIST)
(480) 586-4877
Entity
Organization
Contact information
Practice address
1757 E BASELINE RD, #129, GILBERT, AZ 85233-1532
(480) 545-0661
Mailing address
1757 E BASELINE RD, #129, GILBERT, AZ 85233-1532
(480) 545-0661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008046
AZ
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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