Organization
COMPASS POINT DENTAL
Active
Parent organization
PHOENIX PEDIATRIC DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX PEDIATRIC DENTAL
Authorized official
LUZ PACHECO (HUMAN RESOURCE)
(602) 242-5741
Entity
Organization
Contact information
Practice address
5400 W NORTHERN AVE, SUITE 202, GLENDALE, AZ 85301-1406
(623) 500-5790
Mailing address
6750 N 19TH AVE, PHOENIX, AZ 85015-1127
(602) 242-5741
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4935
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
450924
—
AZ
Enumeration date
01/09/2015
Last updated
02/02/2015
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