Individual
DR. JOSHUA A MONDLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8671 W UNION HILLS DR, SUITE 501, PEORIA, AZ 85382-7005
(623) 583-3960
Mailing address
8671 W UNION HILLS DR, SUITE 501, PEORIA, AZ 85382-7005
(623) 583-3960
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019-026230
IL
1223P0300X
Periodontics
053711-1
NY
1223P0300X
Periodontics
28440
TX
1223P0300X
Periodontics
Primary
D6260
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
877657
—
AZ
Enumeration date
03/31/2006
Last updated
04/05/2016
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