Organization
MESA MOUNTAIN PDC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CHRISTENSEN (CREDENTIALING SPECIALIST)
(801) 305-3460
Entity
Organization
Contact information
Practice address
2855 E BROWN ROAD BUILDING F, STE 23, MESA, AZ 85213
(480) 725-1462
Mailing address
727 E UTAH VALLEY DR, AMERICAN FORK, UT 84003-3345
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/13/2025
Last updated
08/13/2025
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