Organization
MARICOPA FAMILY DENTAL 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
20046 N. JOHN WAYNE PKWY, SUITE 105, MARICOPA, AZ 85139
(520) 316-6100
(520) 568-7312
Mailing address
20046 N. JOHN WAYNE PKWY, SUITE 105, MARICOPA, AZ 85139
(520) 316-6100
(520) 568-7312
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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