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Organization

MNM DENTAL STUDIO PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE BOLIO (INSURANCE COORDINATOR/RECEPTIONIST)
(623) 209-0012
Entity
Organization

Contact information

Practice address
13933 W GRAND AVE, SUITE #302, SURPRISE, AZ 85374-2435
(623) 209-0012
(623) 537-9184
Mailing address
13933 W GRAND AVE, SUITE #302, SURPRISE, AZ 85374-2435
(623) 209-0012
(623) 537-9184

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6611
AZ

Other

Enumeration date
04/28/2008
Last updated
04/28/2008
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