Organization
SURPRISE IMPLANTS & FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHREEDEVI THULASIDAS DDS (OWNER)
(480) 815-5222
Entity
Organization
Contact information
Practice address
14967 W BELL RD, STE 100, SURPRISE, AZ 85374
(623) 233-6236
(480) 248-3133
Mailing address
14967 W BELL RD STE 100, SURPRISE, AZ 85374-3201
(623) 233-6236
(480) 248-3133
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D07677
AZ
Other
Enumeration date
07/16/2017
Last updated
07/21/2022
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