Organization
INTRA DENTAL, INC.
Active
Other names
Cornerstone Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY D SHIM DDS (PRESIDENT)
(310) 227-0944
Entity
Organization
Contact information
Practice address
6135 N 35TH AVE, SUITE 135, PHOENIX, AZ 85017-1950
(602) 973-0325
(602) 973-9704
Mailing address
6135 N 35TH AVE, SUITE 135, PHOENIX, AZ 85017-1950
(602) 973-0325
(602) 973-9704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7163
AZ
Other
Enumeration date
05/13/2007
Last updated
08/06/2007
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