Organization
VILLAGO DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2876 N PINAL AVE STE 4, CASA GRANDE, AZ 85122-7944
(520) 374-2225
(520) 374-2229
Mailing address
2876 N PINAL AVE STE 4, CASA GRANDE, AZ 85122-7944
(520) 374-2225
(520) 374-2229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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