Organization
SV GILBERT, LLC
Active
Other names
Sun Valley Pediatric Dentistry Gilbert
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E BALLARD (CFO, CIO)
(480) 889-9457
Entity
Organization
Contact information
Practice address
3592 S ATHERTON BLVD, SUITE 107, GILBERT, AZ 85297-7443
(480) 889-1877
(480) 889-1876
Mailing address
4435 E HOLMES AVE, MESA, AZ 85206-3372
(480) 889-9457
(480) 696-5505
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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