Organization
DENTAL ON CENTRAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE VAUGHAN (ADMINISTRATOR)
(480) 241-0026
Entity
Organization
Contact information
Practice address
5133 N CENTRAL AVE STE 102, PHOENIX, AZ 85012-1438
(602) 266-1776
Mailing address
5133 N CENTRAL AVE STE 102, PHOENIX, AZ 85012-1438
(602) 266-1776
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
AZ
Other
Enumeration date
05/15/2017
Last updated
07/21/2022
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