Organization
A2ZPD LLC
Active
Other names
A TO Z PEDIATRIC DENTISTRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL R CLARK DDS (DDS)
(480) 503-3764
Entity
Organization
Contact information
Practice address
1810 S CRISMON RD, STE 189, MESA, AZ 85209-3717
(480) 503-3764
(480) 380-0336
Mailing address
1810 S CRISMON RD, STE 189, MESA, AZ 85209-3717
(480) 503-3764
(480) 380-0336
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5179
AZ
1223P0221X
Pediatric Dentistry
7725
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408928
—
AZ
05
—
558133
—
AZ
05
—
713546
—
AZ
Enumeration date
09/29/2010
Last updated
01/16/2014
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