Organization
PACIFIC DENTAL SERVICES FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK DILLENBERG (OWNER)
(714) 845-8500
Entity
Organization
Contact information
Practice address
4559 E. BELL ROAD, STE 106, PHOENIX, AZ 85032
(714) 845-8500
(303) 952-0892
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
03/28/2019
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