Organization
ANDDENTAL
Active
Other names
AZ Family Dental- North
Organization subpart
No
Provider details
NPI number
Authorized official
LINDSAY HAUKELI (OFFICE MANAGER)
(623) 303-8089
Entity
Organization
Contact information
Practice address
28255 N TATUM BLVD STE 4, CAVE CREEK, AZ 85331-2394
(623) 303-8089
(623) 321-9488
Mailing address
28255 N TATUM BLVD STE 4, CAVE CREEK, AZ 85331-2394
(623) 303-8089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174148985
PPO GENERAL DENTIST
AZ
01
—
1336400472
PPO GENERAL DENTIST
AZ
Enumeration date
09/30/2022
Last updated
10/25/2022
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