Organization
ELITE DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOUIL G MAMOOK D.D.S. (OWNER)
(602) 249-9621
Entity
Organization
Contact information
Practice address
2001 W BETHANY HOME RD, PHOENIX, AZ 85015-2471
(602) 249-9621
(602) 841-1916
Mailing address
2001 W BETHANY HOME RD, PHOENIX, AZ 85015-2471
(602) 249-9621
(602) 841-1916
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
06072
AZ
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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