Organization
ELLIOT ROAD DENTAL - ISLAND PLLC
Active
Other names
Island Dental
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (CREDENTIALING DIRECTOR)
(972) 869-3789
Entity
Organization
Contact information
Practice address
1489 W ELLIOT RD STE 101, GILBERT, AZ 85233-5168
(480) 507-9400
Mailing address
1489 W ELLIOT RD STE 101, GILBERT, AZ 85233-5168
(480) 507-9400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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