Organization
DESERT MOUNTAIN ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK CASALE D.D.S. (PRESIDENT)
(623) 594-2888
Entity
Organization
Contact information
Practice address
20542 N LAKE PLEASANT RD, #113, PEORIA, AZ 85382-9749
(623) 594-2888
(623) 328-9474
Mailing address
20542 N LAKE PLEASANT RD, #113, PEORIA, AZ 85382-9749
(623) 594-2888
(623) 328-9474
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
8110
AZ
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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