Organization
ARIZONA PEDIATRIC DENTISTRY AND ORTHODONTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHASHI M. KAPUR D.D.S. (OWNER)
(623) 344-2000
Entity
Organization
Contact information
Practice address
4145 N 108TH AVE, BLDG K-101, PHOENIX, AZ 85037-5463
(623) 344-2000
(623) 344-2007
Mailing address
4145 N 108TH AVE, BLDG K-101, PHOENIX, AZ 85037-5463
(623) 344-2000
(623) 344-2007
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D3801
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F00359
—
AZ
Enumeration date
01/22/2007
Last updated
08/22/2020
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