Organization
CENTER FOR PEDIATRIC DENTISTRY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA ABDOLL (PRACTICE ADMINISTRATOR)
(480) 597-5536
Entity
Organization
Contact information
Practice address
2571 S VAL VISTA DR STE 101, GILBERT, AZ 85295-6233
(480) 597-5536
(480) 597-5624
Mailing address
2571 S VAL VISTA DR STE 101, GILBERT, AZ 85295-6233
(480) 597-5536
(480) 597-5624
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590291
AHCCCS ID #
AZ
Enumeration date
05/29/2007
Last updated
01/14/2020
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