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Organization

BALTA FALLS, LLC

Active
Parent organization
TRILEAL, LLC
Other names
Mountain Vista Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRILEAL, LLC
Authorized official
JONATHON EDWARDS (MANAGER)
(480) 868-1864
Entity
Organization

Contact information

Practice address
3125 W HUNT HWY, UNIT 101, SAN TAN VALLEY, AZ 85142-9315
(480) 868-1864
Mailing address
1945 S ARCO DR, GILBERT, AZ 85295-3017
(480) 868-1864

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009375
AZ

Other

Enumeration date
06/18/2016
Last updated
06/18/2016
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